Arthritis 101 PDF Print E-mail

Arthritis

canemanArthritis is the most common cause of disability in adults. It is the leading cause of physician visits among people above 65 years of age. In the Philippines, there are 11 million people affected by this disease. The crippling pain associated with it can make simple tasks such as walking, stair climbing, bending, or squatting an ordeal. So what is this disease called arthritis? Arthritis comes from the Greek word arthro- meaning joint and –itis meaning inflammation. Simply put arthritis is joint inflammation. There are many causes of arthritis. In fact, there are more than 100 forms of arthritis. The three most common are osteoarthritis, rheumatoid arthritis, and gouty arthritis.

Osteoarthritis is the most common type of arthritis. It is also known as degenerative joint disease, osteoarthrosis, hypertrophic arthritis. It results from the ‘wear and tear’of the cartilage that may be secondary to trauma, infection, and joint malalignment.

To better understand arthritis, let us look at what a joint is. A joint is where two bones meet. At the end of a bone, a spongy layer of tissue is found called cartilage. A cartilage is slippery smooth to ensure smooth motion without the friction that would normally result from bone-on-bone contact. It also acts as a cushion to absorb shock during normal gait. A joint is lined by a synovial tissue which is responsible for secreting synovial fluid that lubricates the joint. The two bones in a joint are held together by ligaments. While muscle and tendon helps support the joint as well as enable it to move.

arthritis01

arthritis02

In osteoarthritis, the cartilage wears down until the bone underneath begins to show. This results in pain, stiffness, swelling, and deformity of the involved joint. The loose cartilages and exposed bone begins to interfere with motion thereby resulting to crepitation. Risk factors for osteoarthritis include old age, obesity, previous injury to the affected joint, and a family history of osteoarthritis.

Rheumatoid Arthritis is an inflammatory type of arthritis. It is an autoimmune disease. An autoimmune disease occurs when the immune system turns against parts of the body it is designed to protect. Thus, rheumatoid arthritis affects not only joints in the body but other tissues as well like the lungs, the skin, blood vessels, etc. Being systemic in nature it affects joints symmetrically meaning both hands or both knees are affected. It can occur at any age and are more frequent in women than in men.

In the joint, rheumatoid arthritis affects the synovium which swells and affects the surrounding structures. The ligaments and capsule becomes less effective stabilizers of the joint leading to instability, contractures, and deformity. The cartilage erodes and pain, swelling, deformity, and stiffness occur. Other symptoms are:

  • Flu-like symptoms such as fever, malaise, weight loss
  • Multiple joint aches and pain usually small joints in a symmetrical fashion
  • Morning stiffness
  • Warm, swollen, deformed joints
  • Nodules or lumps found around the body like the elbow
  • Weakness due to anemia

Gouty Arthritis on the other hand is caused by uric acid crystal deposition in the joint. Uric acid comes from the break down of purines found in food such as in red meats, internal organs, oat meals etc. It occurs as a sudden onset of intense pain and swelling of the involved joint usually affecting the big toe. The ankle, knee, heel may also be affected. The joint is very warm to touch and red. Attacks can be precipitated by alcohol intake, stress, certain drugs, and illnesses. The attacks usually last for 7 days.

Diagnosis

Arthritis is diagnosed by careful evaluation of the history and physical examination. Xrays are taken to visualize changes in the joint. A blood work-up maybe done on certain cases of arthritis. Synovial fluid maybe aspirated from the joint and sent for analysis.

Treatment

It is important to seek medical consult once pain in the joint is felt. Early diagnosis is the key to having a proper treatment plan that will help protect the joint from rapid damage. Each type of arthritis has its own treatment. 
Conservative treatment for Osteoarthritis:

  • Rest
  • Analgesics, or NSAIDs
  • Intra-articular injections includes corticosteroid and viscosupplementation ie.
  • Hyaluronic acid
  • Walking assistive devices ie. Cane
  • Exercises- strenghthens the joint and improves motion


Rheumatoid arthritis on the other hand is treated aggressively by disease modifying drugs such as methotrexate, gold injections, sulfasalazine to slow down the progression of the disease. This may be given in conjuction with pain relievers such as aspirin, ibuprofen, etc. A new form of treatment called biologic agents target specific chemicals in the body to interrupt its progression. Exercises are also very important in the treatment of rheumatoid arthritis.

pills3
Gouty arthritis is treated with cochicine, NSAIDs, or corticosteroid drugs during acute attacks. But the key to the treatment of gout is prevention of acute attacks. This can be done by having a proper diet which means avoiding purine rich foods, avoiding alcohol intake specially alchohol binges, maintaining a proper weight by exercising, and avoiding certain types of drugs such as cyclosporine, low-dose aspirin, diuretics, and niacin. Examples of foods to avoid are sardines, anchovies, brains, liver, kidneys, tripe, sweetbreads, tongue, shellfish (mussels and oysters), fish roe, scallops, peas, lentils, beans and an excessive amount of red meat. For those who have high uric acid levels uricosuric drugs ie. Probenecid or xanthine oxidase inhibitor Allopurinol may be prescribed.

There are a number of surgical procedures available for treating arthritis. The type of procedure that may be done depends on the severity of the disease, the type of arthritis, the activity level and age of the individual. Only an orthopedic doctor can determine which procedure would best suit the condition. These includes:

  • Debridment or removal of damaged lining thru arthroscopy
  • Realignment procedures in the form of osteotomies
  • Arthrodesis or fushion of the severely damaged joint
  • Total Joint Replacement

Total Joint Replacement involves removing the damaged part of the joint and replacing it with an artificial joint. It is one of the most successful orthopedic procedure in the world today. It affords exceptional pain relief, long term durability, and restored function. It is indicated for individuals who have end-stage

blog comments powered by Disqus
 
  • What’s New with AOJR?
  • Proven & Tested
  • facebook

What’s New with AOJR?

 

 

 

caringhand1
 
 
This 2015 AOJR wants to talk to you and your community about arthritis. Take part and join us in  promoting awareness about the social, emotional and health impact of arthritis as well as its evidence based treatments. Help us improve lives by creating awareness. You can contact us by calling 710-8292 or email us at jointspecialists@aojr.ph 
 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

October 2014. Dr. Paul Cesar N. San Pedro represented the Philippines in...

READMORE

Testimonials

 

PROVEN AND TESTED

Who else but our patients can testify to AOJR’s expertise in joint replacement surgery and how we helped improve their lives. Here are what some of our patients have to say:

 

Alcera" After the operation, I thought I wouldn't be ableto enjoy the same lifestyle as I had before. I was wrong, It's amazing how I can still enjoy activites likes dancing and aerobics."

Doris Alcera, 63y.o. Total Knee Replacement, February 2011

READMORE
We love to be your friend on Facebook.
Be part of our fast growing number of fans.

Poll of the Month

How do you keep yourself in shape?

Regular exercise - 8%
Dieting. I watch what I eat - 14%
I take dieting pills - 10%
Combination of exercise & healthy eating - 54%
Enroll in a weight loss program - 14%

Total votes: 50
The voting for this poll has ended on: 11 Apr 2017 - 00:00

www.aojr.ph © 2009. all rights reserved