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cytic fibrosis and artritis

My dother 21 years old has problems with artritis I have read there are a number of problems with joints associated with cystic fibrosis, what is the problems?why it hapends? she takes ibuprofeno and gets better, what do you thing about it? Thanks
Dear questioner,

Thank you for your question. Arthritis is a well known complication of cystic fibrosis and occurs in 5-10% of patients. Arthritis in cystic fibrosis can cause joints to become very painful and during an episode, joints may feel warm to the touch and appear red and swollen. According to the Cystic Fibrosis Trust (please see reference at the end), there are 2 main types of arthritis which are related to cystic fibrosis: “cystic fibrosis associated arthritis” and “hyertrophic pulmonary osteoarthropathy”.

Cystic fibrosis associated arthritis can start at a young age and is defined as having episodes which last less than a week, involve the large joints (such as knees, ankles, wrists and shoulders) and respond to treatment with anti-inflammatory medication such as ibuprofen. Sometimes flu-like symptoms, rashes and fevers may occur during an episode. In between episodes, symptoms tend to disappear.

Hypertrophic pulmonary osteoarthropathy usually starts in young adults with a gradual and constant ache which gets worse over time. X-rays usually reveal new bone formations which can cause “finger clubbing” (the broadened and rounded appearance of fingers and toes). This type of arthritis also tends to affect the large joints such as the knee, ankle and wrist and is usually symmetrical (affects the joints on both sides of the body). Symptoms associated with this type of arthritis usually respond to non steroidal anti-inflammatory drugs such as ibuprofen as well and help to relieve pain and swelling. If symptoms are not relieved, corticosteroids may be used for treatment.

Both types of arthritis tend to get worse during a lung infection. This is because an infection causes the immune system of the body to become more active and arthritis is also an immune disorder. Therefore, treating the lung infection can reduce symptoms associated with arthritis.

There may be other reasons for joint pain in cystic fibrosis. Occasionally arthritis can be a side effect of medication often taken by people with cystic fibrosis such as some antibiotics. Sometimes people with cystic fibrosis may get arthritis due to a family history of arthritis or the normal aging process (although this is unlikely in your 21 year old daughter). Joint pain may also occur due to osteoporosis (low bone mass) which is common in adults with CF. Osteoporosis occurs when more bone is broken down by the body than is formed. There is a range of different medications which are used in the treatment of osteoporosis.

Your daughter should discuss with her cystic fibrosis doctor what type of arthritis she has to ensure she is taking the correct treatments to reduce her symptoms.
Best wishes Fiona

Reference: Cystic Fibrosis Trust. “Clinical Guidelines for the Physiotherapy Management of Cystic Fibrosis”. Association of Chartered Physiotherapists in Cystic Fibrosis. 2002.
The answer is edited by: Fiona Kerr