Arthritis is an inflammation of a joint. Other types of arthritis may be classified as non-inflammatory, inflammatory, septic, and hemorrhagic.

Conditions classified as non-inflammatory arthritis include: amyloidosis; Ehlers-Danlos syndrome; hypertrophic pulmonary osteoarthropathy; metabolic diseases causing osteoarthritis; neurogenic arthropathy; osteoarthritis; osteochondritis; osteochondromatosis; sickle cell disease; subsiding or early infection; and trauma.

Conditions classified as inflammatory arthritis include: gout; ankylosing spondylitis; Lyme disease; partially treated or less infectious bacterial infections; psoriatic arthritis; Reiter's syndrome; rheumatoid disease; and ulcerative colitis.

Conditions classified as septic arthritis include bacterial infections.

Conditions classified as hemorrhagic arthritis include: conditions secondary to anticoagulant treatment; hemangioma; hemophilia; neurogenic arthropathy; pigmented villonodular synovitis; scurvy; thrombocytopenia; trauma with or without fracture; and tumor.

Specific types of arthritis that may result from or are associated with infection include: Arthritis, gonorrheal (see Diagnostic Code: 5004); Arthritis, pneumococcic (see Diagnostic Code: 5005); Arthritis, typhoid (see Diagnostic Code: 5006); Arthritis, syphilitic (see Diagnostic Code: 5007); Arthritis, streptococcic (see Diagnostic Code: 5008); Rheumatic fever (see Diagnostic Code: 6309); and Ulcerative colitis (see Diagnostic Code: 7323). Arthritis may also result from trauma (see Diagnostic Code: 5010); metabolic disorders such as gout (see Diagnostic Code: 5017); and other conditions.

In most arthritic conditions, the onset is slow without patient awareness of the condition. However, there may be an abrupt onset. There is progressive joint involvement with simultaneous inflammation in multiple joints. The initial signs and symptoms may occur in any joint. Signs and symptoms common to most types of arthritis include pain, swelling, and often changes in structure. Tenderness in almost all of the inflamed joints is the most sensitive sign. Other signs and symptoms may include: weight loss; synovial thickening in most involved joints; and symmetrical involvement of small hand and foot joints, wrists, elbows and ankles. Stiffness lasting more than 30 minutes on arising in the morning or after prolonged inactivity and early afternoon fatigue and general discomfort are likely to be present. Deformities of flexion contractures may develop rapidly. Ulnar deviation of the fingers occurs later. Carpal tunnel syndrome may also result from synovitis. Low-grade fever may be present; however, the rheumatoid factor is usually present. There may be progressive destruction of articular and periarticular structures with or without generalized signs and symptoms.

Tests for the condition include: complete blood studies, which may show a normochromic-normocyctic anemia, and an elevated erythrocyte sedimentation rate (ESR); and analysis of the synovial fluid and x-ray, which are usually nonspecific in the first six months. Other tests include: studies of renal and liver functions; antinuclear antibodies (ANA); Tine test or purified protein derivative (PPD); and arthrocentesis for synovial fluid analysis. Based on the type of arthritis being diagnosed, other tests may be ordered. Any four, of the following criteria, must be present 6 weeks or more to classify persons as having rheumatoid arthritis: morning stiffness of one hour or more; arthritis of three or more joints; arthritis of hand joints; and symmetric arthritis. The serum rheumatoid factor must be determined, and there must be radiographic changes.

There is no specific treatment for arthritis; however, the underlying cause may require specific therapy. Education and emotional support are significant considerations. Bedrest and adequate nutrition are encouraged. Drug therapy may include: coated aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and brief use of corticosteroids because of the possible side effects. Other drug therapy considerations include: antimalarials; and gold therapy for persons who do not respond to initial drugs. The individual must be monitored for toxic reactions when receiving gold salt therapy and corticosteriods. Exercise and physical therapy to maintain the range of motion of the affected joints is recommended. Passive exercises are done until the inflammatory response has subsided. Splints and weight loss are recommended. Surgery, such as total joint replacement, may be used to treat severe forms of the condition.

The residuals will depend on the type of arthritis, and the course the disease takes; either remission within two years or persistence of joint symptoms. Persons with negative rheumatoid factors usually have good functional status in activities of daily living (ADL). Ten percent or more may eventually become severely disabled despite treatment. Rheumatoid arthritis greatly affects the life of the person living with the disease. Assistive devices may be used in the bathroom such as raised toilet seats and gripping bars. Other equipment that might be needed include: large-handled eating utensils, a wheel chair, or a cane. Risk factors which interfere with the progress made by patients include: positive rheumatoid factor; poor functional status, due to the inability to perform personal care ADL; having more then 30 inflamed joints involved; and extra-articular signs and symptoms of rheumatoid lung disease.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. See 38 CFR 3.307(a)(3) and §3.309(a) [chronic disease].

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Other specified forms of arthropathy include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies.

• With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003.