Lupus and arthritis are different conditions, but lupus often causes people to develop arthritis or joint pain.
The causes and treatments for lupus and arthritis are different, so people should be aware of the differences between the two conditions.
There may be a genetic link between lupus and arthritis, though there are also significant genetic differences.
In this article, we look at the connection between lupus and arthritis. We also look at the symptoms, treatment, and outlook.
What is lupus?
Lupus is a chronic autoimmune condition characterized by an overactive immune system mistakenly attacking healthy parts of the body.
The areas lupus impacts include:
- skin and mucous membranes
- internal organs, such as the kidneys
- bones and joints
- blood
- brain
The effect lupus has on the body can be severe but varies between individuals.
Around 1.5 million Americans are believed to have lupus, and it is most common in women aged 15 to 44.
There are several different types of lupus. Systemic lupus erythematosus (SLE) accounts for around 70 percent of lupus cases.
What is arthritis?
Arthritis is a chronic health condition affecting around 54.4 million U.S. adults.
Arthritis causes inflammation in the joints, which tends to worsen over time and can cause permanent joint damage. Arthritis typically begins to develop in people of more than 45 years of age.
The two most common types of arthritis are:
- Rheumatoid arthritis (RA), which is an autoimmune disease that occurs when the immune system mistakenly attacks healthy tissue in the joints.
- Osteoarthritis, where the protective tissues in the joints are slowly degraded by wear and tear, with a much lower level of chronic inflammation than RA.
Arthritis erodes the tissue in the joints that stops the ends of bones from scraping against each other. The friction this creates leads to further inflammation. This causes pain and swelling in the joints, eventually restricting their mobility.
How are lupus and arthritis connected?
Lupus causes widespread inflammation throughout the body, including in the joints. This means that it can trigger arthritis. Arthritis or joint pain that doctors refer to as arthralgia is among the most common symptoms of lupus.
People with lupus typically develop arthritis or arthralgia with several other symptoms, such as skin rashes and fatigue.
The form of arthritis triggered by lupus is different to that caused by RA. But, a small subset of people with lupus will have severe joint involvement and an RA-like picture. This rare complication is referred to as rhupus.
Despite this one example of a crossover, there are major differences between RA and arthritis caused by lupus.
These differences include:
- lupus is not erosive while RA can be
- lupus arthritis is much less severe than RA
- the primary joints affected are different
Arthritis in people with lupus tends to affect:
- hands
- knees
- shoulders
- elbows
- feet
There may also be a genetic link between RA and lupus and other autoimmune conditions, such as inflammatory bowel disorder (IBD) and celiac disease.
While autoimmune diseases can share genetic risk factors, there are also significant differences between groups. More research is required to understand what triggers the genetic influences responsible for these conditions.
Diagnosing lupus and arthritis
Both lupus and arthritis are diagnosed based on symptoms. Blood tests can be helpful, too, as can imaging studies. For instance, if hand X-rays show joint erosions, then RA is more likely to be the cause than lupus.
Doctors will first take a person’s medical history and then conduct a physical exam. They will look for signs of inflammation and reductions in the range of motion for affected joints.
A doctor may recommend blood tests to look at the blood cell count, the density of antibodies in the blood, and the type of antibodies present. This blood analysis can help to determine the nature and severity of an autoimmune condition.
Doctors also use lab tests that measure inflammation, such as the ESR or CRP tests, to follow disease activity or support evidence of a flare.
The ESR (sed rate) or CRP (C-reactive protein) lab tests enable doctors to measure inflammation. They are used to track disease activity or support evidence of a flare, for example. Cells known as autoantibodies do not correlate with the progression.
In some cases, a doctor will recommend imaging tests such as X-rays, ultrasound, or a CT or MRI scan. These techniques enable a doctor to examine internal organs and joint tissue or bone damage.
In lupus diagnosis, doctors may recommend CT scans for suspected interstitial lung disease or to look for swollen lymph nodes.
With lupus, doctors may also recommend a kidney biopsy if they suspect the involvement of the kidneys, such as with glomerulonephritis.
Treatment
There are currently no absolute cures for lupus or arthritis. However, some treatments are effective for managing symptoms, reducing further damage to the joints and organs, and for improving someone’s quality of life.
A doctor may recommend physical therapy alongside medication.
Treatments usually involve medication and lifestyle changes. If the conditions have progressed, some people may need surgery to correct damage or prevent further changes.
People with lupus may require strong immunosuppression, which doctors would not recommend for arthritis.
Lupus primarily affects women of childbearing years, so it is vital that doctors also address and prevent problems during pregnancy.
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