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Arthritic damage.

dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
Afternoon all, I hope you are all as well as you can be and that all is well at Helpline Mansions.

Right, my thought, which followed from skezier's post, was this. Do the varying types of arthritis cause different kinds of damage to the same joints? I know, for example, that PA usually starts in the smaller joints (toes, fingers) so would the damage to those joints be different to RA damage of those joints? Are RA-affected hips damaged in the same way as OA-affected ones? I once read that PA tends to miss the hips - is that right or is it one sweeping generalisation too many? AS is another version of this pestilence: does that damage in the same way as OA or RA? That's lots of questions - sorry, but they all share the general theme. DD
Have you got the despatches? No, I always walk like this. Eddie Braben

Comments

  • helpline_teamhelpline_team Posts: 2,007
    edited 30. Nov -1, 00:00
    Oy vey what have I started? All I did was answer a question - I didn't expect the Spanish Inquisition.
    Now, as we've stated a million times on here - we in Helpline Mansions are not qualified to answer techie questions. But as it's you DD, I shall endeavour to come up with a response that makes me sound vaguely knowledgable.
    Is there different damage to the same joints with PA and RA? Interesting question. I think if you looked at two hands, one with PA the other with RA you'd get the same number of bone erosions with both but they'd be less severe with PA. PA tends to affect the DIP joints - the ones closest to the fingernail, whereas with RA it's more likely to be the PIP joints - they're the ones in the middle that bend....or used to bend...or are permanently bent.
    RA and OA hip damage I'd guess would look quite different as RA erodes bone and with OA there's often new bone formation. But RA doesn't often go after the hips, it's more a case of having wreaked havoc with the immune system, RA feels a bit bored and lonely so gets some secondary OA to keep it company.
    I think you're right that PA tends to miss the hips altogether. Yes that is a sweeping generalisation, but you can never have too many sweeping generalisations. AS is a mysterious creature indeed - some of the symptoms of inflammatory arthritis but with added bone growth.
    Well that's all we've got time for, Basil, as Helpline Mansions will shortly be closing for the day. I look forward to your next letter DD.
    All the best
    Paul
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 10. Mar 2011, 14:39
    Cheeky boy. :smile: Stop your kvetching - I know you are not medical tecchies but I did wonder about the types and style of damage. I have PA but it started in my left knee, not my small jonts as is the usual (apparently) but on my last Xray my bones were absolutely beautiful, it's the surrounding bits that are, ooooh, how do I put this politely? - ummmmm - rhyming slang allowed? No? OK.

    It would seem sensible to me that the damage caused by the various strains of this pestilence would also vary. I will ask my rheumatologist the next time I see her. That'll fox her!

    Thank you Paul, I appreciate your taking the time to answer a very basic question. One thinks one is quite well informed then up pops a query - 118 can't help on this one! DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • suzygirlsuzygirl Posts: 2,005
    edited 30. Nov -1, 00:00
    Hi Daisy, I thought that the difference was the place it attacked. The RA attacks the actual inside of joints, whereas the PA attacks where the tendons etc attach to the joints???? I thought that was how they told the difference??

    Will have to check, but that was my understanding, as well as the RF showing in bloods.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Oooooh! Never heard that! Thanks suzygirl, I will dig about too and see what I can unearth. I have to go cook - :sad: . Hate cooking. Hate arthritis too but cooking just about wins that race. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • suzygirlsuzygirl Posts: 2,005
    edited 30. Nov -1, 00:00
    I do love a good puzzle. :grin:

    Ok have checked it out.

    Main differences between RA and the spondylarthropathies are -

    In RA the synovium becomes inflamed causing synovitis, this is more unusal in PA etc as it is the enthesitis that is the problem. Enthesis is the junction or insertion of a ligament or tendon into bone. There is also rarely the symmetry seen in RA or the positve RF.

    Spine tends to be involved in PA but rarely in RA. Common links to psioriasis, colitis and iritis in spondylarthorpathies. Different genes are involved in each. An x ray of sacrolitis would reveal fuzzy edges.

    X - rays for RA reveal destroyed cartilage and eroded bone.

    Still looking, be interesting to see what your rheumy says Daisy. Some people with psoriasis have RA, so must be a discernable difference.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    I have done and am doing the whole symmetry bit, and it has always been the synovial linings which have caused the problems - I have had substantial quantities of fluid drawn off both knees and my right ankle, they only decided it was PA when I had a bout of psoriasis which started in October 06 and ended in about February 07. I dont't have it that often which I put down to the sulph - dermatology told me that that is a common treatment for P and in my case it seems to be effective.

    I am now more muddled. :sad: Never mind, DD is in for a beery week-end and will therefore forget about all this for a few days. Whatever it is, whatever I have, I know it ain't gonna go away. Not now. Never mind eh? Keep injecting and swallowing my girl, miracles don't often happen but unless you give them a chance, DD, they never will! I hope you have a good weekend, suzygirl and thank you.
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • suzygirlsuzygirl Posts: 2,005
    edited 30. Nov -1, 00:00
    Its funny as one rheumy said I had RA and another said I didn't. I have synovitis, symmetrical joint involvement and tendonitis in achilles heels.

    Personally I think someone needs to tell these auto immune disorders to stay in their category, they don't seem to play by the rules!! lol :lol:
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