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Is chronic inflammatory arthritis the same as rheumatoid arthritis?

Q) I'm 63 and have suffered from osteoarthritis for around 10 years. I've recently been diagnosed with chronic inflammatory arthritis, at which time my consultant also used the words rheumatoid arthritis. Although the blood markers were negative, which he said applied to around 30 per cent of sufferers, an MRI showed inflammation and degeneration around the joints of my hands. He's prescribed methotrexate and folic acid. Are these conditions the same? I'd like to refer to my condition correctly.
Nigel, Horsham, East Sussex (Summer 2011)

A) Nigel, sometimes the situation is not 'black and white'. Of course people can (unfortunately) get two different forms of arthritis. If possible we like to keep the diagnoses made for any one person to a minimum. This is known as Occams Razor. William of Ockham was a logician and philosopher who introduced the 'law of parsimony'. Essentially this suggests: 'why use two explanations when one will do'. So, if one diagnosis can explain all your symptoms then this is the preferred assumption, and it does simplify treatment. However, having said all that, people with osteoarthritis can develop other types of arthritis. Chronic inflammatory arthritis is just a generic term to describe the condition and how it differs from osteoarthritis, and in such cases drugs like methotrexate are used. Rheumatoid arthritis is one form of chronic inflammatory arthritis but there are other types, such as psoriatic arthritis and gout. If it's not clear exactly what the underlying condition is then rheumatologists will often just call it chronic inflammatory arthritis.

This answer was provided by Dr Philip Helliwell for the Summer 2011 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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