Arthritis - An Introduction For Patients

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Find out more at http://www.noelhenley.com.
In this presentation I give you an overview of arthritis and its diagnosis and treatment.

I'll share with you my quick three step guide to diagnosing arthritis and teach you the best way to think about ANY arthritis treatment.

Ozark Orthopaedic: Henley C Noel MD
3317 North Wimberly Drive, Fayetteville, AR 72703
(479) 521-2752


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  • \n
  • What is your most valuable asset? (REPEAT) It’s not your bones or your joints or even health, necessarily. It’s YOUR TIME - Do you agree or disagree? It’s the one thing you can’t get more of, right?\n
  • more specifically as it relates to today’s topic... the asset I’m trying to preserve is...\n
  • your PAIN FREE TIME\nStopping arthritis is ultimately about giving yourself more of this asset. You can’t get more time, but you can get more pain-free time. A good first step in that process is learning about the problem of arthritis. This talk is a good introduction.\n
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  • Is it a bad thing? \nSeems like a silly question, but a diagnosis of arthritis is not a reason to panic.\nMost of us know someone with arthritis\nPatients often tell me their mom or grandmother’s hands were bent...\nArthritis can cause significant problems...\n
  • Is it a bad thing? \nSeems like a silly question, but a diagnosis of arthritis is not a reason to panic.\nMost of us know someone with arthritis\nPatients often tell me their mom or grandmother’s hands were bent...\nArthritis can cause significant problems...\n
  • Is it a bad thing? \nSeems like a silly question, but a diagnosis of arthritis is not a reason to panic.\nMost of us know someone with arthritis\nPatients often tell me their mom or grandmother’s hands were bent...\nArthritis can cause significant problems...\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
  • Arthritis is a joint problem, but it can hurt your overall well-being and state of mind. These are non-joint effects.\nMost importantly, however... arthritis is an asset destroyer - remember the asset I mentioned earlier? arthritis is a destroyer of your pain-free time.\n
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  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
  • In the joints\nWhich is where two bones meet together in the body\nSome examples of joints include...\n
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  • Here’s a common example showing you where joints can be found.\n\nAlmost all of you have seen this at Thanksgiving. The shiny, glistening end of the bone is joint cartilage - the shock absorber for this turkey’s knee joint.\n
  • Here is a drawing of two bones coming together to form a joint. Joints are surrounded by a sac of fluid called the joint capsule.\n
  • Arthritis is a wearing away of the smooth cartilage surfaces in the joint. Patients often have bone spurs and loose pieces of cartilage in the joint at the same time. \n
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  • I’ve heard some people confuse the two terms osteoarthritis and osteoporosis. You can have both, but osteoporosis is a thinning of the bones, which is not a form of arthritis.\n
  • remember the turkey leg? - that smooth glistening surface is the problem in OA\n
  • remember the turkey leg? - that smooth glistening surface is the problem in OA\n
  • remember the turkey leg? - that smooth glistening surface is the problem in OA\n
  • remember the turkey leg? - that smooth glistening surface is the problem in OA\n
  • remember the turkey leg? - that smooth glistening surface is the problem in OA\n
  • So if you remember a family member who had arthritis or know someone who has it now, statistically, it’s more likely to be this kind - osteoarthritis\n
  • So if you remember a family member who had arthritis or know someone who has it now, statistically, it’s more likely to be this kind - osteoarthritis\n
  • So if you remember a family member who had arthritis or know someone who has it now, statistically, it’s more likely to be this kind - osteoarthritis\n
  • So if you remember a family member who had arthritis or know someone who has it now, statistically, it’s more likely to be this kind - osteoarthritis\n
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  • This is a much different kind of arthritis than OA. It’s treated differently and acts differently in many ways. \n
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  • In this picture I want you to notice this smooth synovium, or joint lining on the LEFT. The one on the RIGHT with rheumatoid arthritis is jagged and inflamed.\n
  • In this picture I want you to notice this smooth synovium, or joint lining on the LEFT. The one on the RIGHT with rheumatoid arthritis is jagged and inflamed.\n
  • In severe deformity, the fingers point toward the pinkie fingers, the knuckles are very swollen and deformed.\n
  • The first step in diagnosing arthritis is to think about symptoms you have.\n
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  • I frequently see patients with thumb pain who had no pain until they fell or jammed the thumb. The trauma of the fall seems to start the pain of arthritis in these patients.\n
  • I frequently see patients with thumb pain who had no pain until they fell or jammed the thumb. The trauma of the fall seems to start the pain of arthritis in these patients.\n
  • I frequently see patients with thumb pain who had no pain until they fell or jammed the thumb. The trauma of the fall seems to start the pain of arthritis in these patients.\n
  • I am an orthopaedic surgeon, but I specialize in treating hands and arms. These are the most common locations for arthritis in the hands and arms (repeat).\n
  • I am an orthopaedic surgeon, but I specialize in treating hands and arms. These are the most common locations for arthritis in the hands and arms (repeat).\n
  • I am an orthopaedic surgeon, but I specialize in treating hands and arms. These are the most common locations for arthritis in the hands and arms (repeat).\n
  • I am an orthopaedic surgeon, but I specialize in treating hands and arms. These are the most common locations for arthritis in the hands and arms (repeat).\n
  • I am an orthopaedic surgeon, but I specialize in treating hands and arms. These are the most common locations for arthritis in the hands and arms (repeat).\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • When I ask patients what makes their pain worse, these are the most common answers.\n\nBe thinking about whether you have any of these symptoms...\n
  • These are the same steps any conscientious physician will take to make a diagnosis of arthritis. \n\nLet’s go through each of these steps in detail.\n
  • These are the same steps any conscientious physician will take to make a diagnosis of arthritis. \n\nLet’s go through each of these steps in detail.\n
  • These are the same steps any conscientious physician will take to make a diagnosis of arthritis. \n\nLet’s go through each of these steps in detail.\n
  • Thinking about the patter of pain and symptoms is the first step. \n
  • Thinking about the patter of pain and symptoms is the first step. \n
  • Thinking about the patter of pain and symptoms is the first step. \n
  • Take a careful look at your hand or other joints. Sometimes I can tell someone has arthritis just by looking at their hands.\n
  • Take a careful look at your hand or other joints. Sometimes I can tell someone has arthritis just by looking at their hands.\n
  • Take a careful look at your hand or other joints. Sometimes I can tell someone has arthritis just by looking at their hands.\n
  • Press on, move, and feel your joints - you may notice some things for the first time. \n
  • Press on, move, and feel your joints - you may notice some things for the first time. \n
  • Press on, move, and feel your joints - you may notice some things for the first time. \n
  • What if you think you have arthritis, or you’ve been diagnosed with arthritis?\n
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  • In many situations, arthritis pain and symptoms may get better over time. \n
  • In many situations, arthritis pain and symptoms may get better over time. \n
  • In many situations, arthritis pain and symptoms may get better over time. \n
  • In many situations, arthritis pain and symptoms may get better over time. \n
  • In many situations, arthritis pain and symptoms may get better over time. \n
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  • Who treats arthritis? \n
  • Who treats arthritis? \n
  • Who treats arthritis? \n
  • Who treats arthritis? \n
  • Who treats arthritis? \n
  • Who treats arthritis? \n
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  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
  • - Steroid injections can shut down inflammation and provide pain relief\n\n- Surgery: consider it when other treatments are eating away at that valuable asset we talked about (yes, even treatments can destroy it).\n
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  • - you know what it is\n- you know where it is\n- you know what the two main types are\n- I’ve reviewed a quick three step guide to diagnosing arthritis\n- you have heard an overview of treatment options and know whom to call\n
  • - you know what it is\n- you know where it is\n- you know what the two main types are\n- I’ve reviewed a quick three step guide to diagnosing arthritis\n- you have heard an overview of treatment options and know whom to call\n
  • - you know what it is\n- you know where it is\n- you know what the two main types are\n- I’ve reviewed a quick three step guide to diagnosing arthritis\n- you have heard an overview of treatment options and know whom to call\n
  • - you know what it is\n- you know where it is\n- you know what the two main types are\n- I’ve reviewed a quick three step guide to diagnosing arthritis\n- you have heard an overview of treatment options and know whom to call\n
  • - you know what it is\n- you know where it is\n- you know what the two main types are\n- I’ve reviewed a quick three step guide to diagnosing arthritis\n- you have heard an overview of treatment options and know whom to call\n
  • One last comment about treatments for arthritis. You’ll find dozens of treatments recommended by doctors, friends, relatives, and others, ranging from the ones I’ve mentioned here to other more bizarre methods.\n- Here are two questions to ask yourself about any treatment or program\n- the short version of these questions is: is the treatment having an effect, and are its benefits long-lasting?\n- no one can answer these personal questions for you\n
  • One last comment about treatments for arthritis. You’ll find dozens of treatments recommended by doctors, friends, relatives, and others, ranging from the ones I’ve mentioned here to other more bizarre methods.\n- Here are two questions to ask yourself about any treatment or program\n- the short version of these questions is: is the treatment having an effect, and are its benefits long-lasting?\n- no one can answer these personal questions for you\n
  • One last comment about treatments for arthritis. You’ll find dozens of treatments recommended by doctors, friends, relatives, and others, ranging from the ones I’ve mentioned here to other more bizarre methods.\n- Here are two questions to ask yourself about any treatment or program\n- the short version of these questions is: is the treatment having an effect, and are its benefits long-lasting?\n- no one can answer these personal questions for you\n
  • One last comment about treatments for arthritis. You’ll find dozens of treatments recommended by doctors, friends, relatives, and others, ranging from the ones I’ve mentioned here to other more bizarre methods.\n- Here are two questions to ask yourself about any treatment or program\n- the short version of these questions is: is the treatment having an effect, and are its benefits long-lasting?\n- no one can answer these personal questions for you\n
  • One last comment about treatments for arthritis. You’ll find dozens of treatments recommended by doctors, friends, relatives, and others, ranging from the ones I’ve mentioned here to other more bizarre methods.\n- Here are two questions to ask yourself about any treatment or program\n- the short version of these questions is: is the treatment having an effect, and are its benefits long-lasting?\n- no one can answer these personal questions for you\n
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  • Arthritis - An Introduction For Patients

    1. 1. Preserving Your Most Valuable Asset What You Should Know About Arthritis C. Noel Henley, MD 2011
    2. 2. The Asset www.noelhenley.com
    3. 3. The Asset Your Time www.noelhenley.com
    4. 4. The Asset www.noelhenley.com
    5. 5. The AssetMore specifically, www.noelhenley.com
    6. 6. The Asset www.noelhenley.com
    7. 7. The AssetPain-free Time www.noelhenley.com
    8. 8. Who Am I? www.noelhenley.com
    9. 9. Who Am I?• Husband, Father, Board-certified orthopaedic surgeon www.noelhenley.com
    10. 10. Who Am I?• Husband, Father, Board-certified orthopaedic surgeon• Specializing in hand, wrist, and elbow www.noelhenley.com
    11. 11. Who Am I?• Husband, Father, Board-certified orthopaedic surgeon• Specializing in hand, wrist, and elbow• My goal is to restore and preserve function - with surgery or without www.noelhenley.com
    12. 12. Who Am I?• Husband, Father, Board-certified orthopaedic surgeon• Specializing in hand, wrist, and elbow• My goal is to restore and preserve function - with surgery or without• Orthopaedic surgeons provide surgical and non-surgical care for arthritis patients www.noelhenley.com
    13. 13. What Will You Learn? www.noelhenley.com
    14. 14. What Will You Learn?• What arthritis is www.noelhenley.com
    15. 15. What Will You Learn?• What arthritis is• Where it is www.noelhenley.com
    16. 16. What Will You Learn?• What arthritis is• Where it is• The two common types www.noelhenley.com
    17. 17. What Will You Learn?• What arthritis is• Where it is• The two common types• 3 steps to self-diagnosis www.noelhenley.com
    18. 18. What Will You Learn?• What arthritis is• Where it is• The two common types• 3 steps to self-diagnosis• An overview of treatment options www.noelhenley.com
    19. 19. What is Arthritis? www.noelhenley.com
    20. 20. What is Arthritis?• Arthr- : joint www.noelhenley.com
    21. 21. What is Arthritis?• Arthr- : joint• -itis : inflammation www.noelhenley.com
    22. 22. What is Arthritis?• Arthr- : joint• -itis : inflammation• Joint inflammation that causes pain and stiffness www.noelhenley.com
    23. 23. Is it a Bad Thing? www.noelhenley.com
    24. 24. Is it a Bad Thing?• Most of you know someone with arthritis www.noelhenley.com
    25. 25. Is it a Bad Thing?• Most of you know someone with arthritis• “My mom’s hands were bent and useless - I don’t want to end up that way” www.noelhenley.com
    26. 26. Is it a Bad Thing?• Most of you know someone with arthritis• “My mom’s hands were bent and useless - I don’t want to end up that way”• Pain, stiffness, trouble walking and using your hands or doing what you love www.noelhenley.com
    27. 27. Is it a Bad Thing? www.noelhenley.com
    28. 28. Is it a Bad Thing?• Non-joint effects www.noelhenley.com
    29. 29. Is it a Bad Thing?• Non-joint effects • depression www.noelhenley.com
    30. 30. Is it a Bad Thing?• Non-joint effects • depression • anxiety www.noelhenley.com
    31. 31. Is it a Bad Thing?• Non-joint effects • depression • anxiety • feelings of helplessness, dependence www.noelhenley.com
    32. 32. Is it a Bad Thing?• Non-joint effects • depression • anxiety • feelings of helplessness, dependence • activity limitations, job limitations www.noelhenley.com
    33. 33. Is it a Bad Thing?• Non-joint effects • depression • anxiety • feelings of helplessness, dependence • activity limitations, job limitations • difficulty participating in family/social activities www.noelhenley.com
    34. 34. Take-Home Point 1 www.noelhenley.com
    35. 35. Take-Home Point 1Arthritis is a Destroyer of your pain-free time www.noelhenley.com
    36. 36. Where is Arthritis? www.noelhenley.com
    37. 37. Where is Arthritis?• In the joints www.noelhenley.com
    38. 38. Where is Arthritis?• In the joints• Places where two bones meet www.noelhenley.com
    39. 39. Where is Arthritis?• In the joints• Places where two bones meet • fingers www.noelhenley.com
    40. 40. Where is Arthritis?• In the joints• Places where two bones meet • fingers • elbows www.noelhenley.com
    41. 41. Where is Arthritis?• In the joints• Places where two bones meet • fingers • elbows • knees www.noelhenley.com
    42. 42. Where is Arthritis?• In the joints• Places where two bones meet • fingers • elbows • knees • hips www.noelhenley.com
    43. 43. Take-Home Point 2 www.noelhenley.com
    44. 44. Take-Home Point 2Arthritis is a problem with the joints www.noelhenley.com
    45. 45. Where is Arthritis? Turkey Leg Bone
    46. 46. Where is Arthritis?
    47. 47. Where is Arthritis? Normal Joint
    48. 48. Where is Arthritis?
    49. 49. Where is Arthritis? Arthritic Joint
    50. 50. Where isArthritis?Most Common Locations: fingers knees hips spine
    51. 51. Types of Arthritis
    52. 52. What Types of Arthritis Are There? www.noelhenley.com
    53. 53. What Types of Arthritis Are There?• Osteoarthritis www.noelhenley.com
    54. 54. What Types of Arthritis Are There?• Osteoarthritis• Rheumatoid arthritis www.noelhenley.com
    55. 55. What Types of Arthritis Are There?• Osteoarthritis• Rheumatoid arthritis• Less common www.noelhenley.com
    56. 56. What Types of Arthritis Are There?• Osteoarthritis• Rheumatoid arthritis• Less common • gout and psoriasis www.noelhenley.com
    57. 57. What Types of Arthritis Are There?• Osteoarthritis• Rheumatoid arthritis• Less common • gout and psoriasis • infection-related www.noelhenley.com
    58. 58. What Types of Arthritis Are There?• Osteoarthritis• Rheumatoid arthritis• Less common • gout and psoriasis • infection-related • fracture/trauma-related www.noelhenley.com
    59. 59. Osteoarthritis
    60. 60. Osteoarthritis (OA) www.noelhenley.com
    61. 61. Osteoarthritis (OA)• “Wear and tear” arthritis www.noelhenley.com
    62. 62. Osteoarthritis (OA)• “Wear and tear” arthritis• usually affects fingers, knees, and hips www.noelhenley.com
    63. 63. Osteoarthritis (OA)• “Wear and tear” arthritis• usually affects fingers, knees, and hips• develops slowly with age www.noelhenley.com
    64. 64. Osteoarthritis (OA)• “Wear and tear” arthritis• usually affects fingers, knees, and hips• develops slowly with age• a problem with cartilage in the joint www.noelhenley.com
    65. 65. Osteoarthritis (OA)• “Wear and tear” arthritis• usually affects fingers, knees, and hips• develops slowly with age• a problem with cartilage in the joint • hard, slippery covering over the ends of bone www.noelhenley.com
    66. 66. Osteoarthritis (OA) www.noelhenley.com
    67. 67. Osteoarthritis (OA)• Who has it? www.noelhenley.com
    68. 68. Osteoarthritis (OA)• Who has it? • 27 million Americans (about 10% of the population) www.noelhenley.com
    69. 69. Osteoarthritis (OA)• Who has it? • 27 million Americans (about 10% of the population) • more common in women than men after 45 years of age www.noelhenley.com
    70. 70. Osteoarthritis (OA)• Who has it? • 27 million Americans (about 10% of the population) • more common in women than men after 45 years of age • more common in overweight people and in those who stress their joints more (like runners) www.noelhenley.com
    71. 71. Osteoarthritis (OA) www.noelhenley.com
    72. 72. Osteoarthritis (OA)• Problem starts in the cartilage www.noelhenley.com
    73. 73. Osteoarthritis (OA)• Problem starts in the cartilage • normally allows bones to glide smoothly together www.noelhenley.com
    74. 74. Osteoarthritis (OA)• Problem starts in the cartilage • normally allows bones to glide smoothly together • the shock absorber in the joint www.noelhenley.com
    75. 75. Osteoarthritis (OA)• Problem starts in the cartilage • normally allows bones to glide smoothly together • the shock absorber in the joint • wears away with OA - becomes rougher - bone eventually grinds on bone www.noelhenley.com
    76. 76. Take-Home Point 3 www.noelhenley.com
    77. 77. Take-Home Point 3Osteoarthritis starts out as a cartilage problem www.noelhenley.com
    78. 78. Osteoarthritis (OA) www.noelhenley.com
    79. 79. Osteoarthritis (OA)• Other changes www.noelhenley.com
    80. 80. Osteoarthritis (OA)• Other changes • extra bone growth happens as the joint wears out (bone spurs) www.noelhenley.com
    81. 81. Osteoarthritis (OA)• Other changes • extra bone growth happens as the joint wears out (bone spurs) • the joint produces more fluid www.noelhenley.com
    82. 82. Osteoarthritis (OA)• Other changes • extra bone growth happens as the joint wears out (bone spurs) • the joint produces more fluid • swelling www.noelhenley.com
    83. 83. Osteoarthritis (OA)• Other changes • extra bone growth happens as the joint wears out (bone spurs) • the joint produces more fluid • swelling • cysts on fingers www.noelhenley.com
    84. 84. Osteoarthritis (OA) www.noelhenley.com
    85. 85. Osteoarthritis (OA)• Patterns in the hand and arm www.noelhenley.com
    86. 86. Osteoarthritis (OA)• Patterns in the hand and arm • some genetic (runs in families) component www.noelhenley.com
    87. 87. Osteoarthritis (OA)• Patterns in the hand and arm • some genetic (runs in families) component • small knots form at the end of the finger www.noelhenley.com
    88. 88. Osteoarthritis (OA) www.noelhenley.com
    89. 89. Osteoarthritis (OA)• Patterns in the hand and arm www.noelhenley.com
    90. 90. Osteoarthritis (OA)• Patterns in the hand and arm • bottom (or base) of the thumb gets swollen and deformed www.noelhenley.com
    91. 91. Rheumatoid Arthritis
    92. 92. Rheumatoid Arthritis (RA) www.noelhenley.com
    93. 93. Rheumatoid Arthritis (RA)• “Inflammation” arthritis www.noelhenley.com
    94. 94. Rheumatoid Arthritis (RA)• “Inflammation” arthritis• The immune system attacks normal joint tissues www.noelhenley.com
    95. 95. Rheumatoid Arthritis (RA)• “Inflammation” arthritis• The immune system attacks normal joint tissues• Starts in the joint lining first - not in the cartilage www.noelhenley.com
    96. 96. Take-Home Point 4 www.noelhenley.com
    97. 97. Take-Home Point 4Rheumatoid arthritis starts out as a joint lining problem www.noelhenley.com
    98. 98. Rheumatoid Arthritis (RA) www.noelhenley.com
    99. 99. Rheumatoid Arthritis (RA)• Pattern is usually symmetrical - equal in both hands www.noelhenley.com
    100. 100. Rheumatoid Arthritis (RA)• Pattern is usually symmetrical - equal in both hands• Patients may have fatigue, fevers, and feel ill more than OA patients www.noelhenley.com
    101. 101. Rheumatoid Arthritis (RA) www.noelhenley.com
    102. 102. Rheumatoid Arthritis (RA)• Who has it? www.noelhenley.com
    103. 103. Rheumatoid Arthritis (RA)• Who has it? • 1.3 million people in the US (much less common than OA) www.noelhenley.com
    104. 104. Rheumatoid Arthritis (RA)• Who has it? • 1.3 million people in the US (much less common than OA) • more common in women than men www.noelhenley.com
    105. 105. Rheumatoid Arthritis (RA)• Who has it? • 1.3 million people in the US (much less common than OA) • more common in women than men • usually begins in middle age and is more common with increasing age www.noelhenley.com
    106. 106. Rheumatoid Arthritis (RA) www.noelhenley.com
    107. 107. Rheumatoid Arthritis (RA)• Problem starts in the joint lining www.noelhenley.com
    108. 108. Rheumatoid Arthritis (RA)• Problem starts in the joint lining • inflamed joint lining invades and destroys the joint surface www.noelhenley.com
    109. 109. Rheumatoid Arthritis (RA)• Problem starts in the joint lining • inflamed joint lining invades and destroys the joint surface • erodes/weakens ligaments around joints, causing large deformities www.noelhenley.com
    110. 110. Rheumatoid Arthritis
    111. 111. Rheumatoid Arthritis
    112. 112. Rheumatoid Arthritis
    113. 113. Rheumatoid Arthritis (RA) www.noelhenley.com
    114. 114. SymptomsDo You Have Arthritis?
    115. 115. Do You Have Arthritis? www.noelhenley.com
    116. 116. Do You Have Arthritis?• Pain in a joint is the most common symptom www.noelhenley.com
    117. 117. Do You Have Arthritis?• Pain in a joint is the most common symptom • at rest www.noelhenley.com
    118. 118. Do You Have Arthritis?• Pain in a joint is the most common symptom • at rest • after activity www.noelhenley.com
    119. 119. Do You Have Arthritis?• Pain in a joint is the most common symptom • at rest • after activity• Stiffness, swelling, and crunching www.noelhenley.com
    120. 120. Do You Have Arthritis?• Pain in a joint is the most common symptom • at rest • after activity• Stiffness, swelling, and crunching• Weakness, deformity - may be pain-free www.noelhenley.com
    121. 121. Do You Have Arthritis? www.noelhenley.com
    122. 122. Do You Have Arthritis?• Pain usually comes on slowly; may start with a fall or sprain www.noelhenley.com
    123. 123. Do You Have Arthritis?• Pain usually comes on slowly; may start with a fall or sprain• Stiffness usually worse in the morning www.noelhenley.com
    124. 124. Do You Have Arthritis?• Pain usually comes on slowly; may start with a fall or sprain• Stiffness usually worse in the morning• Initially, pain comes on after activity; later, aching pain may be in the background all the time www.noelhenley.com
    125. 125. Do You Have Arthritis? Common Locations www.noelhenley.com
    126. 126. Do You Have Arthritis? Common Locations• Hand www.noelhenley.com
    127. 127. Do You Have Arthritis? Common Locations• Hand • fingertips www.noelhenley.com
    128. 128. Do You Have Arthritis? Common Locations• Hand • fingertips • thumb www.noelhenley.com
    129. 129. Do You Have Arthritis? Common Locations• Hand • fingertips • thumb• Wrist www.noelhenley.com
    130. 130. Do You Have Arthritis? Common Locations• Hand • fingertips • thumb• Wrist• Elbow www.noelhenley.com
    131. 131. Do You Have Arthritis? Painful Activities www.noelhenley.com
    132. 132. Do You Have Arthritis? Painful Activities• Pinching www.noelhenley.com
    133. 133. Do You Have Arthritis? Painful Activities• Pinching• Gripping www.noelhenley.com
    134. 134. Do You Have Arthritis? Painful Activities• Pinching• Gripping• Writing www.noelhenley.com
    135. 135. Do You Have Arthritis? Painful Activities• Pinching• Gripping• Writing• Sewing/Knitting www.noelhenley.com
    136. 136. Do You Have Arthritis? Painful Activities• Pinching • Twisting• Gripping• Writing• Sewing/Knitting www.noelhenley.com
    137. 137. Do You Have Arthritis? Painful Activities• Pinching • Twisting• Gripping • Opening jars• Writing• Sewing/Knitting www.noelhenley.com
    138. 138. Do You Have Arthritis? Painful Activities• Pinching • Twisting• Gripping • Opening jars• Writing • Turning the steering wheel• Sewing/Knitting www.noelhenley.com
    139. 139. Do You Have Arthritis? 3 Quick Steps to Diagnosis www.noelhenley.com
    140. 140. Do You Have Arthritis? 3 Quick Steps to Diagnosis1.Think www.noelhenley.com
    141. 141. Do You Have Arthritis? 3 Quick Steps to Diagnosis1.Think2.Look www.noelhenley.com
    142. 142. Do You Have Arthritis? 3 Quick Steps to Diagnosis1.Think2.Look3.Touch www.noelhenley.com
    143. 143. Do You Have Arthritis? Step 1: Think www.noelhenley.com
    144. 144. Do You Have Arthritis? Step 1: Think•Is the pain in the knuckles or joints? www.noelhenley.com
    145. 145. Do You Have Arthritis? Step 1: Think•Is the pain in the knuckles or joints?•Did the pain start gradually? www.noelhenley.com
    146. 146. Do You Have Arthritis? Step 1: Think•Is the pain in the knuckles or joints?•Did the pain start gradually?•Are your joints stiff in the mornings? www.noelhenley.com
    147. 147. Do You Have Arthritis? Step 2: Look www.noelhenley.com
    148. 148. Do You Have Arthritis? Step 2: Look•Is your thumb or finger swollen around the joint? www.noelhenley.com
    149. 149. Do You Have Arthritis? Step 2: Look•Is your thumb or finger swollen around the joint?•Are your joints bent or crooked? www.noelhenley.com
    150. 150. Do You Have Arthritis? Step 2: Look•Is your thumb or finger swollen around the joint?•Are your joints bent or crooked?•Is there redness around the joint? www.noelhenley.com
    151. 151. Do You Have Arthritis? Step 3: Touch www.noelhenley.com
    152. 152. Do You Have Arthritis? Step 3: Touch•Does pushing on the joint cause pain? www.noelhenley.com
    153. 153. Do You Have Arthritis? Step 3: Touch•Does pushing on the joint cause pain?•Is there pain when you bend it? www.noelhenley.com
    154. 154. Do You Have Arthritis? Step 3: Touch•Does pushing on the joint cause pain?•Is there pain when you bend it?•Can you feel grinding or crunching? www.noelhenley.com
    155. 155. What Now?
    156. 156. What Now? www.noelhenley.com
    157. 157. What Now?• Doing nothing about arthritis may be appropriate www.noelhenley.com
    158. 158. What Now?• Doing nothing about arthritis may be appropriate• Rarely is arthritis dangerous www.noelhenley.com
    159. 159. What Now?• Doing nothing about arthritis may be appropriate• Rarely is arthritis dangerous • Exception: rheumatoid arthritis in the neck www.noelhenley.com
    160. 160. What Now?• Doing nothing about arthritis may be appropriate• Rarely is arthritis dangerous • Exception: rheumatoid arthritis in the neck• Worst case if you do nothing... www.noelhenley.com
    161. 161. What Now?• Doing nothing about arthritis may be appropriate• Rarely is arthritis dangerous • Exception: rheumatoid arthritis in the neck• Worst case if you do nothing... • slow worsening of function over years www.noelhenley.com
    162. 162. What Now? www.noelhenley.com
    163. 163. What Now?• Best case www.noelhenley.com
    164. 164. What Now?• Best case • a “burning out” of the arthritis pain www.noelhenley.com
    165. 165. What Now?• Best case • a “burning out” of the arthritis pain • stiffness, deformity, and abnormal function may persist with no pain www.noelhenley.com
    166. 166. What Now?• Best case • a “burning out” of the arthritis pain • stiffness, deformity, and abnormal function may persist with no pain • disease may not get much worse www.noelhenley.com
    167. 167. What Now?• Best case • a “burning out” of the arthritis pain • stiffness, deformity, and abnormal function may persist with no pain • disease may not get much worse • no one can predict this for you www.noelhenley.com
    168. 168. When to Get Help www.noelhenley.com
    169. 169. When to Get Help• When pain and stiffness are stopping you from doing what you want to do www.noelhenley.com
    170. 170. When to Get Help• When pain and stiffness are stopping you from doing what you want to do• When you’ve tried treatments on your own that don’t work any more www.noelhenley.com
    171. 171. Who Treats Arthritis? www.noelhenley.com
    172. 172. Who Treats Arthritis?• Primary care doctors and nurses www.noelhenley.com
    173. 173. Who Treats Arthritis?• Primary care doctors and nurses• Specialists www.noelhenley.com
    174. 174. Who Treats Arthritis?• Primary care doctors and nurses• Specialists • Rheumatologists (non-surgeon joint doctors) www.noelhenley.com
    175. 175. Who Treats Arthritis?• Primary care doctors and nurses• Specialists • Rheumatologists (non-surgeon joint doctors) • Orthopaedic surgeons www.noelhenley.com
    176. 176. Who Treats Arthritis?• Primary care doctors and nurses• Specialists • Rheumatologists (non-surgeon joint doctors) • Orthopaedic surgeons• Others www.noelhenley.com
    177. 177. Who Treats Arthritis?• Primary care doctors and nurses• Specialists • Rheumatologists (non-surgeon joint doctors) • Orthopaedic surgeons• Others • physical therapists www.noelhenley.com
    178. 178. How is it Treated? www.noelhenley.com
    179. 179. How is it Treated?• Medication (over the counter and prescription) www.noelhenley.com
    180. 180. How is it Treated?• Medication (over the counter and prescription)• Heat/Ice www.noelhenley.com
    181. 181. How is it Treated?• Medication (over the counter and prescription)• Heat/Ice• Rubs and creams www.noelhenley.com
    182. 182. How is it Treated?• Medication (over the counter and prescription)• Heat/Ice• Rubs and creams• Splints www.noelhenley.com
    183. 183. How is it Treated?• Medication (over the counter and prescription)• Heat/Ice• Rubs and creams• Splints• Exercise www.noelhenley.com
    184. 184. How is it Treated? www.noelhenley.com
    185. 185. How is it Treated?• Steroid injections www.noelhenley.com
    186. 186. How is it Treated?• Steroid injections • very small amounts www.noelhenley.com
    187. 187. How is it Treated?• Steroid injections • very small amounts • much different than steroid pills www.noelhenley.com
    188. 188. How is it Treated?• Steroid injections • very small amounts • much different than steroid pills • PAIN: I numb it up first! www.noelhenley.com
    189. 189. How is it Treated?• Steroid injections • very small amounts • much different than steroid pills • PAIN: I numb it up first!• Surgery - when is it time? www.noelhenley.com
    190. 190. How is it Treated?• Steroid injections • very small amounts • much different than steroid pills • PAIN: I numb it up first!• Surgery - when is it time? • when other things stop working www.noelhenley.com
    191. 191. Surgery www.noelhenley.com
    192. 192. Surgery• Types www.noelhenley.com
    193. 193. Surgery• Types • arthritis removal - take out bone/joint www.noelhenley.com
    194. 194. Surgery• Types • arthritis removal - take out bone/joint • joint replacement (metal or plastic) www.noelhenley.com
    195. 195. Surgery• Types • arthritis removal - take out bone/joint • joint replacement (metal or plastic) • “clean out” surgeries www.noelhenley.com
    196. 196. Surgery www.noelhenley.com
    197. 197. Surgery• Results www.noelhenley.com
    198. 198. Surgery• Results • stops pain www.noelhenley.com
    199. 199. Surgery• Results • stops pain • improves function www.noelhenley.com
    200. 200. Surgery• Results • stops pain • improves function • reliable for most patients BUT - every patient is different! www.noelhenley.com
    201. 201. Making a decision www.noelhenley.com
    202. 202. Making a decision• No treatment or disease is risk-free www.noelhenley.com
    203. 203. Making a decision• No treatment or disease is risk-free • Risks of doing nothing www.noelhenley.com
    204. 204. Making a decision• No treatment or disease is risk-free • Risks of doing nothing • Risks of non-surgical treatment www.noelhenley.com
    205. 205. Making a decision• No treatment or disease is risk-free • Risks of doing nothing • Risks of non-surgical treatment • Risks of surgery www.noelhenley.com
    206. 206. Making a decision• No treatment or disease is risk-free • Risks of doing nothing • Risks of non-surgical treatment • Risks of surgery• No one can decide for you www.noelhenley.com
    207. 207. Making a decision• No treatment or disease is risk-free • Risks of doing nothing • Risks of non-surgical treatment • Risks of surgery• No one can decide for you • Many tools out there (providers and treatments) www.noelhenley.com
    208. 208. Where Do I Start? www.noelhenley.com
    209. 209. Where Do I Start?• Start with the doctor or nurse you know best and trust www.noelhenley.com
    210. 210. Where Do I Start?• Start with the doctor or nurse you know best and trust• Ask friends for recommendations www.noelhenley.com
    211. 211. Where Do I Start?• Start with the doctor or nurse you know best and trust• Ask friends for recommendations• Medicare or insurance may have rules about seeing one doctor or the other www.noelhenley.com
    212. 212. Where Do I Start?• Start with the doctor or nurse you know best and trust• Ask friends for recommendations• Medicare or insurance may have rules about seeing one doctor or the other• They can help you decide if going to a specialist is necessary or wise www.noelhenley.com
    213. 213. Summary www.noelhenley.com
    214. 214. Summary• You know what arthritis is www.noelhenley.com
    215. 215. Summary• You know what arthritis is• You know where it is www.noelhenley.com
    216. 216. Summary• You know what arthritis is• You know where it is• Osteoarthritis and Rheumatoid Arthritis www.noelhenley.com
    217. 217. Summary• You know what arthritis is• You know where it is• Osteoarthritis and Rheumatoid Arthritis• 3 steps to self-diagnosis www.noelhenley.com
    218. 218. Summary• You know what arthritis is• You know where it is• Osteoarthritis and Rheumatoid Arthritis• 3 steps to self-diagnosis• You have heard an overview of treatment options and whom to call next www.noelhenley.com
    219. 219. Final Questions About Treatments www.noelhenley.com
    220. 220. Final Questions About Treatments• Is it wasting your most valuable asset (time)? www.noelhenley.com
    221. 221. Final Questions About Treatments• Is it wasting your most valuable asset (time)? • Is there a more efficient way of treatment? www.noelhenley.com
    222. 222. Final Questions About Treatments• Is it wasting your most valuable asset (time)? • Is there a more efficient way of treatment?• Does it preserve the pain-free, functional time you have? www.noelhenley.com
    223. 223. Final Questions About Treatments• Is it wasting your most valuable asset (time)? • Is there a more efficient way of treatment?• Does it preserve the pain-free, functional time you have? • Does the treatment have a lasting benefit? www.noelhenley.com
    224. 224. Final Questions About Treatments• Is it wasting your most valuable asset (time)? • Is there a more efficient way of treatment?• Does it preserve the pain-free, functional time you have? • Does the treatment have a lasting benefit?• A doctor cannot answer these questions www.noelhenley.com
    225. 225. www.noelhenley.com
    226. 226. Learn more about your hand and arm problems atwww.noelhenley.com www.noelhenley.com
    227. 227. References• Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. 2008 Jan;58(1):26-35.• Hootman JM, Helmick CG. Projections of US prevalence of arthritis and associated activity limitations. Arthritis Rheum. 2006 Jan;54(1):226-29.• Simon L, Lipman SL, et al. Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis. 2nd ed. American Pain Society. Glenview, IL; 2002. www.noelhenley.com

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