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JOINT PROBLEM

Arthritis

Osteoarthritis

Join pain

Osteoporosis etc

arth - joint

itis – inflammation

Arthritis – inflammation of the joint's

Arthritis Facts-

ØArthritis affects nearly 70 million Americans, or one   in every three adults.
Ø      Arthritis is the leading cause of disability in the   United States – accounting for 17.5 percent of those

          on disability.

Ø      A survey conducted by the Centers for Disease

        Control and Prevention projects that the

           number of Americans over 65 who

          suffer from osteoarthritis will double to 41 million by  2030.

Osteoarthritis-

   There are more than 100 different types of arthritis.  The most common type is called osteoarthritis, which is sometimes known as degenerative joint disease (DJD).  It is most often the result of normal “wear and tear” and occurs to some extent  in all people as they age.  

Joints Affected by Osteoarthritis-

 

Hip

Knee

Spine

All joints can be effected,  however, the most commonly involved are the weight bearing joints such as the hip, knee and spine.  They must withstand the significant forces generated by walking and running, and therefore are prone to wearing out.

What are Joints?

Joints are the places where the bones meet.  The body would be immobile if not for the movements afforded by the joints.  Joints can be large or small, and permit movements as varied as walking, bending, reaching, and performing fine motor skills.

Hip joint-

The hip is a simple ball and socket joint.  The upper end of the thigh bone (femur) is the ball.  It fits snugly into the socket, a part of the pelvis called the acetabulum. 

Knee Joint-

The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thighbone (femur) which rotates on the upper end of the shinbone (tibia), and the knee cap (patella) which slides in a groove on the end of the femur.

Cartilage-

Within the joints, the ends of the bones are covered with a smooth, white, glistening material called hyaline cartilage.  When normal, this material cushions the underlying bone against excessive pressure and allows the joint to move easily and without pain.

When the articular cartilage is damaged or injured, it usually goes through a staged process of softening, flaking, fragmenting, and finally complete loss, where the underlying bone is exposed. This process is commonly known as osteoarthritis or OA.

Menisci-

The articular cartilage on both ends of the knee joint never actually come in direct contact with one another.  They are separated by a thin film of joint fluid and two “shock absorbers” made of a different type of cartilage and known as the menisci (meniscus).
  Arthritis Risk Factors-
ØObesity - Generally, the more weight a person carries, the greater the pressure on weight-bearing joints of the body.

 

ØPast injury in a joint - There is an increased risk of developing OA in a joint that is not properly aligned or one that has been injured.

 

ØOccupational factors - Repetitive tasks, overworking the joints and overtiring muscles that protect a joint increase the risk for OA in that joint.

 

ØGenetics - osteoarthritis in all its various forms appears to have a strong genetic connection. Gene mutations may be a factor in predisposing individuals to develop OA.
Arthritis signs and symptoms-
ØJoint Pain
ØCrepitis (grinding)
ØJoint Deformity
ØOsteophytes
ØJoint Stiffness

Joint Pain and Stiffness

 

Ø   The main symptoms associated with

      osteoarthritis are painful and stiff joints.                               

Ø   The symptoms can be quite debilitating.
Ø   Typically, stiffness is worse in the morning,

       lasting less than 30 minutes.

Creaking or Grinding Sounds

    Crepitis is the medical term for the  grinding sound often heard when attempting to move the affected joint

 t    Sometimes moving the joint through the full normal range of motion may not even be possible

Joint Deformity-

The arthritic knee joint can develop a deformity in  which the joint itself becomes angled

Valgus deformity is the term used to describe what many people commonly refer to as being “knock kneed.”

Varus deformity is the term used to describe what is referred to as being “bowlegged.”

Osteophytes-

Joints also may appear swollen, caused by new bony growths called osteophytes (bone spurs) or sometimes, by extra fluid in the joint.

How is Arthritis Diagnosed?

ØSigns and symptoms
ØHistory and physical examination
ØX-Rays
ØBlood Tests
ØAnalysis of Joint Fluid

Treating Arthritis-

ØAlthough there is no cure for osteoarthritis, proper treatment can help relieve the symptoms and prevent or correct serious joint problems.
Ø
ØThere are two general classes of treatments, surgical and nonsurgical.

ØAlthough there is no cure for osteoarthritis, proper treatment can help relieve the symptoms and prevent or correct serious joint problems.
Ø
ØThere are two general classes of treatments, surgical and nonsurgical.

 

Ø Nonsurgical

  1. Health and behavior modifications - physical therapy,           exercise, weight loss.

  2. Drug therapy – Pain relievers, NSAIDs, COX2 inhibitors 

  3. Intra-articular injections – steroids, viscosupplementation

ØSurgical 

    1. Arthroscopy - Day surgery, done through small holes

  2. Arthroplasty - Total Joint Replacement

NSAIDs-NSAIDs – Non Steroidal Anti-inflammatory Drugs

Ø  NSAIDs are first line therapy drugs that are   used to both relieve pain and to decrease   inflammation.
Ø  Some examples of NSAIDs are Motrin,      Feldene, and Indocin.
Ø  Many people cannot take NSAIDs because of   there side effects including GI upset and an   increased risk of bleeding

Intra-articular Injections-

There are two main types of intra-articular injections.

 

1. Steroids – Injected into the joint to decrease                   inflammation.

          2. Viscosupplementation – Injected into the joint to  provide lubrication

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