Q: What is inflammatory osteoarthritis? Is this different from "regular" osteoarthritis?

A: For most people familiar with osteoarthritis (OA), the term “inflammatory osteoarthritis” sounds like an oxymoron. That’s because we typically think of arthritis as being either inflammatory (such as rheumatoid arthritis [RA]) or non-inflammatory (such as OA).

However, there is a form of OA that is clearly inflammatory. It typically comes on suddenly in middle-aged women, affecting the last (closest to the fingernail) and middle joints of the fingers. For someone unfamiliar with inflammatory osteoarthritis, it can easily be confused with other forms of inflammatory arthritis that affect the fingers, such as RA or psoriatic arthritis.

If you have sudden pain and swelling of the joints in your fingers, it’s important to get a proper diagnosis, because treatment for this inflammatory form of OA is different from treatment for RA or typical OA. Inflammatory osteoarthritis is generally treated with nonsteroidal anti-inflammatory drugs and, very rarely, corticosteroid injections directly into the affected joints. The disease-modifying antirheumatic drugs, such as methotrexate and leflunomide (Arava) prescribed for RA are not appropriate for this type of arthritis.

A physician who is familiar with your clinical, laboratory and X-ray findings will be able to provide the proper diagnosis and therapy for this condition.

Paul Howard, MD, Rheumatologist