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ARTHRITIS

ARTHRITIS. Osteoarthritis (OA). Epidemiology The most common joint disorder worldwide Before age 50, men are more likely to have OA than women. After age 50, women are more likely affected.

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ARTHRITIS

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  1. ARTHRITIS

  2. Osteoarthritis (OA) Epidemiology • The most common joint disorder worldwide • Before age 50, men are more likely to have OA than women. • After age 50, women are more likely affected. • Most commonly affects the weight bearing joints in the leg (hip, knee, ankle), spine (cervical, lumbar) and the hand

  3. Osteoarthritis Defined as a gradual loss of joint cartilage, combined with bony outgrowths at joint margins and mild synovial inflammation. X-ray findings: decreased joint space, spurs Cartilage Stages Stage 1 – normal cartilage Stage 2 – aging cartilage Stage 3 – osteoarthritis

  4. Osteoarthritis

  5. Osteoarthritis Multiple Factors Excess body weight Previous injury to joint Genetics Developmental deformities Gender

  6. Osteoarthritis Clinical Features Joint pain that lessens with rest Morning stiffness of less than 30 minutes Crepitus Bony tenderness and enlargement No palpable warmth Monoarticular and asymmetric involvement of joint For advanced cervical and lumbar spine involvement: numbness, weakness, “sciatica” Limitation of range of motion

  7. Osteoarthritis Treatment Goals Relieve symptoms Maintain range of motion Maintain functionality, activities of daily living Limit physical disability Avoid drug toxicity

  8. Osteoarthritis Treatment Non pharmacologic therapy A. Physical Therapy * Exercises: range of motion, strengthening, aerobic conditioning * Modalities: Hot/Cold compress with TENS B. Occupational Therapy * Assistive devices for activities of daily living C. Weight loss program for ideal body weight D. Patient education * Joint protection techniques, home exercises etc.

  9. Osteoarthritis

  10. Osteoarthritis Pharmacologic Therapy A. Oral * Anti-inflammatory agents * Glucosamine sulfate – slows joint damage * Collagen hydrolysate B. Local * Corticosteroid injections * Viscosupplementation - Hyaluronic acid

  11. Osteoarthritis Surgery - for patients with severe functional impairment and pain not adequately controlled with medical therapy - Arthroscopic debridement and lavage - Total Joint Arthroplasty * significant pain relief offered * possible complication: loosening of prostheses * indicated for older patients

  12. Gouty Arthritis

  13. Gouty Arthritis A disease mostly of adult men (30-60yrs old) caused by the deposition of monosodium urate crystals in joint tissue.

  14. Gouty Arthritis Multiple Factors Genetics Diet * beans, nuts, organ meat, sardines, anchovies mushrooms, spinach, asparagus, cauliflower, gravies, beer and other alcoholic beverages Excess body weight Medication * thiazide diuretics, aspirin, cyclosporine, chemotherapy agents

  15. Gouty Arthritis Clinical Features Warm, swollen, red, and painful joint most commonly affecting the big toe * other joints that may be affected are the ankle, midfoot, heel and knee Walking is difficult or impossible After many years, tophi may develop over the fingers, ears, knees, or elbows * monitor kidney function (BUN, Creatinine)

  16. Gouty Arthritis Treatment Cold compress Pharmacologic Therapy A. Colchicine B. Anti-inflammatory agents C. Allopurinol Diet modification Weight loss: target ideal body weight

  17. Summary Different kinds of arthritis and treatment options Arthritis is a joint problem vs. Osteoporosis which is a bone problem (demineralization) Be informed, ask questions You can and should exercise Practice moderation Do not self medicate Listen to your body and listen to your doctor Ultimately, the decision is yours

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