Skeletal – Part 7

1. Skeletal – Part 7

2. Arthritis • The term arthritis describes over 100 different inflammatory or degenerative diseases that damage the joints. • In all its forms, arthritis is the most widespread, crippling disease in the US. • 1 out of 7 Americans suffer its ravages. • All forms of arthritis have the same initial symptoms: • Pain, stiffness, and swelling of the joint. • Then, depending on the specific form, certain changes in the joint occur.

3. Types of Arthritis • Acute Forms of Arthritis • Usually result from bacterial invasion. • Are treated with antibiotic drugs. • The synovial membrane thickens and fluid production decreases, leading to increased friction and pain. • Chronic Forms of Arthritis • Include osteoarthritis, rheumatoid arthritis, and gouty arthritis.

4. Osteoarthritis • Osteoarthritis – “Wear-and-tear arthritis”; Chronic, degenerative condition that typically affects the aged. • Most common form of arthritis. • Affects the articular cartilages. • Softening, fraying, and eventual breakdown of the cartilage. • The exposed bone thickens and extra bone tissue, called bone spurs, grow. • The bone spurs protrude into the joint cavity, which restricts joint movement.

5. Osteoarthritis: Symptoms • Symptoms: • Stiffness on arising that lessens with activity. • The affected joints may make a crunching noise (crepitus) when moved. • Joints most commonly affected: Fingers, the cervical and lumbar joints of the spine, and the knees and hips. • Usually slow and irreversible, but it is rarely crippling.

6. Osteoarthritis: Treatments • In most cases, its symptoms are controllable with: • A mild analgesic such as aspirin • Moderate activity to maintain joint mobility • Rest when the joint becomes very painful • Some people claim that rubbing capsaicin (a hot pepper extract) and taking glucosamine helps relieve joint pain.

7. Rheumatoid Arthritis • Rheumatoid Arthritis – A chronic inflammatory disorder. • Onset is insidious and usually occurs between the ages of 40-50. • It affects three times as many women as men. • Joints affected: Fingers, wrists, ankles, and feet. • Joints are usually affected in a symmetrical manner. • For example, if the right elbow is affected, most likely the left elbow will be affected also.

8. Rheumatoid Arthritis • Is an autoimmune disorder. • A disorder in which the body’s immune system attempts to destroy its own tissues.

9. Progression of Rheumatoid Arthritis • Inflammation of the synovial membranes. • Membranes thicken and the joints swell as synovial fluid accumulates. • Inflammatory cells enter the joint cavity and produce pannus, an abnormal tissue that clings to and erodes articular cartilage. • Scar tissue forms and eventually ossifies, and the bone ends become firmly fused and often deformed.

10. Symptoms of Rheumatoid Arthritis • All stages involve restricted joint movement • Extreme pain • Not all cases progress to the crippling stage.

11. Rheumatoid Arthritis: Treatments • Powerful drugs that can neutralize the inflammatory chemicals in the joint space and (hopefully) prevent joint deformity. • Aspirin (anti-inflammatory agent) • Exercise to maintain as much joint mobility as possible. • Cold packs to relieve the swelling and pain. • Heat to relieve morning stiffness. • Replacement joints are the last resort.

12. Gouty Arthritis • Gouty Arthritis (Gout) – Disease in which uric acid accumulates in the blood and may be deposited as needle-shaped crystals in the soft tissues of joints. • Uric acid is a normal waste product of nucleic acid metabolism. • Most common in males and rarely appears before the age of 30. • Tends to run in the family, so genetic factors are definitely implicated.

13. Gouty Arthritis: Symptoms • Symptoms: • Leads to an agonizing painful attack that typically affects a single joint, often in the great toe. • Untreated gout can be very destructive: the bone ends fuse and the joint becomes immobilized.

14. Gouty Arthritis: Treatments • Treatments: • Several drugs are successful in preventing acute gout attacks. • Patients are advised to lose weight if obese. • Avoid foods high in nucleic acids such as liver, kidneys, and sardines. • Avoid alcohol, which inhibits the excretion of uric acid by the kidneys.

15. Long-Term Bone Health • It cannot be emphasized enough that bones have to be physically stressed to remain healthy. • When we remain active physically and muscles and gravity pull on the skeleton, the bones respond by becoming stronger. • If we are totally inactive, they become thin and fragile.

16. Osteoporosis • Osteoporosis – Bone-thinning disease. • Afflicts half of women over 65 and 20% of men over the age of 70. • Makes the bones so fragile that even a hug or a sneeze can cause bones to fracture. • The bones of the spine and the neck of the femur are particularly susceptible.

17. Causes of Osteoporosis • Estrogen deficiency that occurs after menopause is strongly implicated as the cause of osteoporosis. • Other factors that may contribute to osteoporosis: • Diet poor in calcium, vitamin D, and protein. • Smoking • Insufficient weight- bearing exercise to stress the bones.