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Degenerative Joint Disease
Several types of arthritis appear to be related to an altered state of hypersensitivity. Erythema nodosum is a skin disease characterized by the formation of reddened nodules on the anterior surface of the lower extremities. In the majority of cases pain may arise in various joints and sometimes swelling appears. Lymph nodes at the hilus of the lung (the site of entrance of bronchus, blood vessels, and nerves) are enlarged. The synovitis disappears in the course of several weeks or months. Although this is not always so, many cases are associated with drug hypersensitivity, with evolving infections such as tuberculosis, coccidioidomycosis, and leprosy, and with Boeck's sarcoidosis, a systemic disease in which nodules form in the lymph nodes and in other organs and structures of the body. Synovitis of this sort occurs in 10 to 15 percent of patients with sarcoidosis. Occasionally, sarcoid joint disease becomes chronic and may simulate rheumatoid arthritis.
Palindromic (recurring) rheumatism is an arthritis of unknown cause. There is no fever. Each attack lasts but a day or two and leaves no permanent effects. Nevertheless palindromic rheumatism rarely remits completely and in perhaps one-third of cases eventuates in rheumatoid arthritis. Polymyalgia rheumatica, a relatively frequent although only recently recognized condition occurring in older people, is characterized by aching and stiffness in the muscles in the region of the hips and shoulders, but the joints proper seem not to be involved. There does seem to be some relationship to one type of arterial inflammation, temporal or giant cell arteritis. Polymyalgia rheumatica is not usually accompanied by serious systemic abnormalities and is treated with small doses of corticosteroids.
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