6 ARTHRITIS AND ARTHRALGIA
General Discussion
Several different terms are often used to describe joint disorders resulting in joint pain. Arthralgia means joint pain. Arthritis implies the presence of an inflammatory component to the disorder. Arthropathy is a general term meaning joint disease but usually means that there is some degree of cartilage damage. Rheumatoid disease, infection, and crystal deposition are examples of conditions which produce an inflammatory response and a resultant cartilage loss. Osteoarthritis, or degenerative joint disease, occurs primarily as a result of cartilage breakdown, but often has a component of secondary inflammation. This chapter focuses on arthritis; however, some of the medications and conditions listed below may cause arthralgia without an inflammatory process.
Before attributing a patient’s pain to arthritis, the physician must consider other potential causes of the pain. These potential diagnoses include intra-articular processes distinct from arthritis (impingement, neoplasm) as well as periarticular sources of pain (bursitis, tendonitis). Patients may also have referred pain from an adjacent site or a distant site as occurs with radiculopathy and spinal stenosis.
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