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One of the more painful versions of osteoarthritis is called erosive arthritis, a largely unexplained condition that strikes mostly in the hands. With this form of arthritis, not only is inflammation said to be more intense, but radiography can actually view the eroding bone and cartilage. The condition tends to appear around the age of 50, striking as many as a dozen postmenopausal women for every man.
What distinguishes erosive arthritis, or erosive osteoarthritis (EOA), from typically generalized rheumatoid arthritis is how it is often centered on the hands, particularly the joints of the fingers. This hard-worked but fragile network of bones, ligaments and cartilage, when viewed in an x-ray, will show enlarged joints and bone that is visibly degraded. Another major distinction is that the erosive variety invariably involves pain and swelling, with the joints forming into small bulbs if left untreated.
According to a 2010 report from the Johns Hopkins University School of Medicine, a typical patient with erosive arthritis will exhibit radiological signs of bone degradation in the distal and proximal interphalangeal joints of the fingers. These are the joints at the tip and base of each finger. Often, cysts appear at these joints as well as synovitis — characterized by swelling around the outer membrane of each joint.
Many among the elderly suffer from a more generalized form of osteoarthritis. It can strike as many as three in four adults over 65. Erosive arthritis, on the other hand, strikes no more than one in seven of those patients with osteoarthritis. Occasionally, other conditions can be initially mistaken for erosive osteoarthritis, such as gout or psoriatic arthritis. Radiologists, however, can easily find the characteristic degradations of EOA, with names like "saw tooth" and "gull wing" to match how they look in an x-ray.
Treatment for erosive arthritis will depend on the severity of the pain and bone degradation. Occupational and physical therapy can help to optimize the flexibility, strength and control of the fingers into old age. Over-the-counter or prescription pain medication is commonly recommended to lessen the pain of joint inflammation. Other medications like the malaria drug hydroxychloroquine also have proven successful with lessening symptoms in the long term. This latter drug is regularly prescribed to sufferers of rheumatoid arthritis.
Scientists have yet to determine exactly what causes erosive or rheumatoid arthritis, which triggers the body's immune system to begin attacking its own joint structure. Genetic inheritance as well as diet, level of fitness and environment all are prime suspects in 2011. Smoking also may increase a person's risk.