Arthritis

“Arthritis” is a broad term used to describe inflammation of the joints. There are many subsets of arthritis, but the arthritis seen in lupus closely resembles rheumatoid arthritis in that it is symmetric (affects the same locations on either side of the body) and usually affects the small joints of the hands, wrists, and feet. Unlike rheumatoid arthritis, erosion of bone usually does not occur, but the hands may appear deformed if there is laxity of the tendons or ligaments. [The medical name for this condition is Jaccoud’s arthropathy. Fingers affected by this condition can be manually straightened but will curve or turn to one side if left alone.] About 95% of lupus patients will experience arthritis or arthralgias (joint pains) at some point during the course of their disease.

Polyarthralgia and polyarthritis, defined as arthralgias or arthritis affecting 5 or more joints, are the most common joint problems seen in people with SLE. In fact, over 50% of lupus patients possess this ailment upon their initial diagnosis. Morning stiffness is also common in lupus. Often people with this condition find that a warm shower in the morning helps to loosen the synovial (joint) fluid and help the body to limber up for the day.

Both large joints, such as the knees, shoulders, and elbows, and small joints, such as the toe and finger joints, can be affected by lupus arthritis. However, pain in the groin should be given special attention by your doctor [especially if you take steroid medications], since this may indicate a more serious problem known as osteonecrosis. Sometimes fluid may accumulate in a joint. In the medical realm, this buildup of fluid is called an effusion and may require draining by your doctor. However, swelling in the joints caused by lupus will improve with lupus medications.

The joint pain and swelling caused by lupus can be helped by certain medications, including NSAIDs, such as naproxen or ibuprofen. Arthritis may also be helped by daily antimalarial therapy (Plaquenil). If necessary, severe polyarthritis can be treated with certain steroids and immunosuppressive medications, such as methotrexate. Your doctor will decide which treatment plan will best alleviate your lupus arthritis.

Sources

  • “Arthritis.” Medical Dictionary. 26 June 2009 <http://medical-dictionary.thefreedictionary.com/arthritis>.
  • Petri, Michelle. “Lupus Information.” Nov. 2002. The Johns Hopkins Arthritis Center. 26 June 2009. <http://www.hopkins-arthritis.org/arthritis-info/lupus/>.
  • Schur, Peter H. “General Symptomology.” The Clinical Management of Systemic Lupus Erythematosus. Ed. Peter H. Schur. 2nd ed. Philadelphia: Lippincott-Raven, 1996. 10.
  • Ziminski, Carol M. “Musculoskeletal Manifestations.” The Clinical Management of Systemic Lupus Erythematosus. Ed. Peter H. Schur. 2nd ed. Philadelphia: Lippincott-Raven, 1996. 47-65.