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What is Arthropathy?

Arthropathy is the collective medical term for any disease of a joint.

A joint is a site where two bones meet, or articulate. The two articulating bone surfaces are covered by smooth tissue called articular cartilage, a firm but flexible connective tissue that allows the bones to slide over each other smoothly and without friction.  It also acts as a shock absorber during bone movement.  

Common Arthropathic Disorders

Numerous arthropathic disorders can affect the joints. The most common one is arthritis, a condition characterized by inflammation of the joints. There are over 100 different types of arthritis - the most common being osteoarthritis and rheumatoid arthritis.

  • Osteoarthritis: Osteoarthritis is a degenerative joint disease. This is the most common type of arthritis and occurs often in the elderly. This disease affects the cartilage that cushions and protects the ends of the bones in a joint. The cartilage starts to wear away over time. In extreme cases, the cartilage can completely degrade, leaving nothing to prevent painful bone-on-bone rubbing. Bone may also bulge or stick out at the end of a joint in what is known as a bone spur. Osteoarthritis causes joint pain and can limit your normal range of motion (the ability to freely move and bend a joint). 
  • Rheumatoid Arthritis: This is an autoimmune disease in which the body's immune system attacks healthy joints, tissues, and organs. Rheumatoid arthritis is a disease of the synovium, a soft tissue lining the joint spaces that creates fluid to lubricate and nourish the joint. Rheumatoid arthritis mostly affects the joints of the hands, feet, wrists, elbows, knees, and ankles bilaterally (both sides of the body at once).  No other form of arthritis is symmetrical in this way.

Causes of Arthropathy

Arthropathy is mainly caused by the wearing-out of the cartilage covering the bone ends in a joint. This may be due to excessive strain over prolonged periods of time, or other joint diseases, injury or deformity. Primary arthropathy is commonly associated with aging and general degeneration of the joints, whereas secondary arthropathy is associated with the consequence of another disease or condition, such as repeated trauma or surgery to the joint structures, congenital abnormalities, familial history, environmental factors, obesity, diabetes, and hormone disorders. 

Signs and Symptoms of Arthropathy

Some of the common signs and symptoms of arthropathy include:

  • Persistent Pain
  • Joint stiffness
  • Warm, tender, and swollen joints
  • Decreased range of motion
  • Redness of the skin around the joint
  • Fever, tiredness, and loss of appetite
  • Deformed joints (severe cases)
  • Bone spurs

Diagnosis of Arthropathy

In order to diagnose arthropathy, your physician may employ the following methods:

  • Physical examination to check for accumulation of fluids and warmth or redness around the joints, range of motion, and pain.
  • Arthrocentesis, in which fluid around the joints is extracted using a syringe for joint fluid analysis to rule out infection, gout, and other causes of arthropathy
  • Blood tests to look into specific types of antibodies, such as ANA (antinuclear antibody) and RF (rheumatoid factor) that are known to trigger arthropathy
  • X-ray, MRI, and CT scans for a detailed evaluation of the soft tissues and joints, severity of the disease, and to confirm the diagnosis.

Treatment for Arthropathy

Treatment for arthropathy includes both non-surgical as well as surgical options. Your doctor will decide the best option based on the condition of your arthropathy.

Nonsurgical treatment options may include :

  • Ice: Application of ice packs on the joints to decrease swelling and pain
  • Activity Modification: Avoiding activities and habits that trigger symptoms 
  • Physical Therapy: Regular exercise regimen to improve range of motion and strengthen joints
  • Anti-inflammatory Medication: Medications like naproxen and ibuprofen to relieve inflammation and pain
  • Cortisone Injection: If physical therapy, medications, rest, and activity modification do not yield the desired results, a cortisone injection may be helpful. Cortisone is a very effective anti-inflammatory medicine and long-term pain reliever.

Surgical treatment options may include:

  • Synovectomy:  A surgical procedure to remove inflamed synovium tissue that lines the inside of the joint capsule.
  • Tendon repair: A surgical procedure to repair the loosened or torn tendons due to inflammation and joint injury.
  • Joint fusion: A surgical procedure to realign or stabilize a joint and to promote pain relief. The procedure involves fastening bone ends together until they fully heal and become one. This method is used when a joint replacement option is ruled out.
  • Total joint replacement: A surgical procedure in which a damaged part of your joint is removed and replaced with an artificial joint prosthesis made of plastic or metal.