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Resources » Articles/Knowledge Sharing » Health
Arthritis - Joint Pain- Management
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Joint pain is a very common condition. It can be due to
Rheumatoid arthritis
Osteoarthritis-
Many old people get affected . Arthritis means “inflamed joint.”
Arthritis is a chronic and disabling condition and it limits the patient’s activities. So this can become a “Crippling disease’
symptoms of arthritis
• Swelling
• Joint pain
• Loss of motion
• Stiffness
Rheumatoid arthritis –
Rheumatoid arthritis is a systemic autoimmune disease which causes inflammation and tissue damage in
joints (arthritis), synovitis and tendon sheaths,
An association exists between RA and Human Herpes Virus (HHV6 )
Epstein-Barr virus (EBV) infection
It’s a polyarthritis affecting women 3 times more commonly than men
Joints involved-
Small joints of hand, feet and cervical spine are affected
Larger joints - shoulder and knee
Morning stiffness of joints creates a lot of discomfort and problems.
Systemic manifestations of RA
-Anemia
-Inflammation in the-
1. Sclera of the eye
2. Pericardium,
3. Pleura, and
4. Lungs
Skin –
The most characteristic sign - subcutaneous rheumatoid nodule
• Erythema nodosum
• Pyoderma gangrenosum, a necrotizing dermatosis
Heart
Pericarditis,
Endocarditis
Cardiac failure
Kidneys
Vasculitis causes glomerululopathy.
Amyloidosis due to chronic inflammation.
Lungs
Pleural effusions
Lung fibrosis
Vasculitis
Eye
Scleritis
Episcleritis
Keratoconjunctivitis sicca leads to dry eye, dry mouth
Seronegative arthritis can be associated with many eye problems like conjunctivitis, uveitis, etc.
Hematological ( changes in blood)
Anemia
Neutropenia.
Constitutional symptoms
Low grade fever, weight loss, malaise, morning stiffness, loss of appetite and
Fatigue,
Investigations -
Rheumatoid factor (RA) – This is an autoantibody
Full blood count, erythrocyte sedimentation rate (ESR), C-reactive protein
Liver enzymes, renal function,
and other immunological tests (e.g. antinuclear antibody/ANA)
American College of Rheumatology Diagnostic criteria
• 1, 2, 3, 4 for at least 6 wks
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• 1. Morning stiffness of >1 hour most mornings
• 2. Arthritis and soft-tissue swelling of >3 of 14 joints joint groups
• 3. Symmetric arthritis
• 4. Arthritis of hand joints
• 5. Subcutaneous nodules in specific places
• 6. Rheumatoid factor - level above the 95th percentile
• 7. Radiological changes of joint erosion
Management -
It is not a curable disease. Rx is aimed at reducing symptoms.
Orthopedic consultation is necessary.
Rheumatoid arthritis is a systemic disease . Joints involved- Small joints of hand
Morning stiffness of joints creates a lot of problems.
Finger deformities occur in longstanding cases
Boutonniere fingers.
The finger is painful and swollen around the PIP ( proximal interphalangeal joint) joint in early stages.
Orthpedician will advise X-ray to rule out any avulsion fracture.
Other conditions that can cause the boutonniere deformity are - burns and prolonged inflammation of proximal interphalangeal joint
Swan-neck deformity
Osteoarthritis-
This is a degenerative joint disease .
It occurs due to calcium deficiency which leads to bone weakness. Interphalangeal joints- joints in finger get affected.It affects joint cartilages. Bones get fractured easily. Old people should be careful to avoid falls in bathroom ( which is very common), etc as they develop fracture femur easily. This again limits activity
Nonsteroidal anti-inflammatory analgesic drugs offer symptomatic relief but they don’t cure the disease.
Disease modifying anti-rheumatoid drugs like
Chloroquine, hydroxychloroquine, D-penicillamine are used.
Hydroxychloroquine is preferred over chloroquine as it has less eye related side effects.
• Gold salts
• Methotrexate (MTX) – The most useful DMARD
• Minocycline
• Sulfasalazine (SSZ)
• Azathioprine
• Ciclosporin A
• Precautions-
• Monitor for side effects related to liver, bone marrow and kidney
Corticosteroids – Act as immunosuppressants
Long -term side effects is a main concern
Physiotherapy has an important role in management.
Immunomodulators
Calcium supplements are helpful in osteoarthritis.
Recent advances in management-
Joint replacement surgery –
Done for hip and knee joints.
People who have these types of problems can join online support groups and discuss their problems
Photo shows arthritis affected fingers
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| Author: Jonathan Phillip Obregon 02 Dec 2008 | Member Level: Silver Points : 2 | Thank you for this very informative post. I am sure that many will benefit to such information. It has been a proven fact that many people as they age, will suffer sooner or later this kind of problem. By knowing such disease and having an idea about it, it would be easier to deal with it should the time comes. Or even perhaps learn how to prevent such from happening.
| | Author: drsachin eye retina surgeon 12 Jan 2009 | Member Level: Diamond Points : 0 | Read more at http://arthritis-sac.blogspot.com/
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