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  • Facts about Arthritis

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    Types of Arthritis

    While the most common form of arthritis - osteoarthritis- is most prevalent in people over 60, arthritis in its various forms can start as early as infancy. Some forms affect people in their young-adult years as they are beginning careers and families and still others start during the peak career and child-rearing years.

    Arthritis-related joint problems include pain, stiffness, inflammation and damage to joint cartilage (the tough, smooth tissue that covers the ends of the bones, enabling them to glide against one another) and surrounding structures. Such damage can lead to joint weakness, instability and visible deformities that, depending on the location of joint involvement, can interfere with the most basic daily tasks such as walking, climbing stairs, using a computer keyboard, cutting your food or brushing your teeth.

    For many people with arthritis, however, joint involvement is not the extent of the problem. Many forms of arthritis are classified as systemic, meaning they can affect the whole body. In these diseases, arthritis can cause damage to virtually any bodily organ or system, including the heart, lungs, kidneys, blood vessels and skin. Arthritis-related conditions primarily affect the muscles and the bones.

    Arthritis causes pain, loss of movement and sometimes swelling.

    • Osteoarthritis, a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. It is the most prevalent form of arthritis.
    • Rheumatoid arthritis, an autoimmune disease in which the joint lining becomes inflamed as part of the body's immune system activity. Rheumatoid arthritis is one of the most serious and disabling types, affecting mostly women.
    • Gout, which affects mostly men. It is usually the result of a defect in body chemistry. This painful condition most often attacks small joints, especially the big toe. Fortunately, gout almost always can be completely controlled with medication and changes in diet.
    • Ankylosing spondylitis, a type of arthritis that affects the spine. As a result of inflammation, the bones of the spine grow together.
    • Juvenile arthritis, a general term for all types of arthritis that occur in children. Children may develop juvenile rheumatoid arthritis or childhood forms of lupus, ankylosing spondylitis or other types of arthritis.
    • Systemic lupus erythematosus (lupus), a serious disorder that can inflame and damage joints and other connective tissues throughout the body.
    • Scleroderma, a disease of the body's connective tissue that causes a thickening and hardening of the skin.
    • Fibromyalgia, in which widespread pain affects the muscles and attachments to the bone. It affects mostly women.

    What's new in testing for arthritis?- Anti CCP2 Test

    WHAT IS AN ANTI-CCP2 TEST AND HOW IS IT USED TO DIAGNOSE RHEUMATOID ARTHRITIS?

    CCP stands for cyclic citrullinated peptide. And it's a particular type of protein that some patients or some people will have in their bodies.

    In rheumatoid arthritis, patients with rheumatoid arthritis begin to make antibodies against these particular proteins, and it turns out to be a very specific laboratory finding in rheumatoid arthritis. These types of antibodies are not present in everybody with rheumatoid arthritis. In fact, they probably are in about 75 percent of people who ultimately have "rheumatoid arthritis. But when they're there, there are not a lot of other reasons for them to be there, so they are a very specific marker help identify a patient who's developing rheumatoid arthritis.

    They're also present early, so they're very useful early in the course of diagnosis, perhaps sometimes even before all of the symptoms have manifested themselves.

    WHAT DOES ANTI-CCP2 INDICATE?

    While the rheumatoid factor is more common in rheumatoid arthritis patients, many patients with a positive test do not have rheumatoid arthritis. Furthermore, the presence of the rheumatoid factor has less prognostic significance than the CCP2. Of interest is that if your rheumatoid factor is negative, you are less likely to have a positive CCP2. Both blood tests are recommended in the initial evaluation of a patient with suspected rheumatoid arthritis.

    HOW IS IT USED?

    A CCP2 test may be ordered along with or following a Rheumatoid factor (RF) test to help diagnose Rheumatoid arthritis (RA). CCP2 may also be ordered to help evaluate the likely development of RA in patients with undifferentiated arthritis - those whose symptoms suggest but do not yet meet the ACR criteria for RA. According to American College of Rheumatology, approximately 95% of patients with a positive CCP2 will develop RA in the future.

    WHEN IS IT ORDERED?

    CCP2 is primarily ordered along with an RF test when a patient has previously undiagnosed inflammatory arthritis or has been diagnosed with undifferentiated arthritis. It may be ordered as a follow-up test to a negative RF test when clinical signs, such as symmetrical joint pain and inflammation, lead the doctor to suspect RA.

    WHAT DOES THE TEST RESULT MEAN?

    As a rule, test results outside the context of clinical signs and symptoms cannot be judged. Nonetheless, when patients are positive for both CCP and RF, it is very likely that they have RA and it is likely that they may develop a more severe form of the disease. When patients are positive for CCP but not RF and clinical signs suggest RA, then it is likely that they have early RA or that they will develop RA in the future.

    When patients are negative for CCP but have a positive RF, then the clinical signs and symptoms are more vital in determining whether they have RA or some other inflammatory condition. When patients are negative for both CCP and RF, then it is less likely that they have RA. It must be emphasized, however, that RA is a clinical diagnosis and may be made in the absence of positive autoantibodies.



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