ARTHRITIS A WHITE COAT VIEW DR. VISPI JOKHI ORTHOPEDIC SURGEON
WHAT IS ARTHRITIS? <ul><li>Arthritis means inflammation of a joint. </li></ul><ul><li>Synonymous terms are rheumatism  </l...
NORMAL JOINT
TYPES OF ARTHRITIS <ul><li>Over 200 types are known but the main ones are: </li></ul><ul><li>Osteoarthritis. </li></ul><ul...
PRIMARY OSTEOARTHROSIS <ul><li>Arthritis of ageing. </li></ul><ul><li>Load bearing joints involved. </li></ul><ul><li>Most...
OSTEOARTHRITIS WHAT HAPPENS?
OSTEOARTHRITIS
OSTEOARTHRITIS  HOW TO TREAT? <ul><li>Drugs only for pain relief. </li></ul><ul><li>Exercises static range of movement and...
OSTEOARTHRITIS
SECONDARY OSTEOARTHROSIS <ul><li>Post traumatic,post infective or following osteonecrosis. </li></ul><ul><li>End stage art...
RHEUMATOID ARTHRITIS <ul><li>Probably auto-immune disorder. </li></ul><ul><li>Polyarticular small joint affectation follow...
RHEUMATOID ARTHRITIS <ul><li>Under the weather a myth with no scientific basis. </li></ul><ul><li>“ Khatta” in fact good f...
RHEUMATOID ARTHRITIS WHAT HAPPENS?
RHEUMATOID ARTHRITIS
RHEUMATOID ARTHRITIS TREATMENT <ul><li>Drugs for symptomatic relief and disease modification. </li></ul><ul><li>Exercises ...
RHEUMATOID ARTHRITIS TREATMENT <ul><li>Inverted Pyramid approach. </li></ul><ul><li>Disease modifying drugs toxic but effe...
ANKYLOSING SPONDYLITIS <ul><li>Definitely auto-immune disorder. </li></ul><ul><li>Starts from back bone followed by spine ...
ANKYLOSING SPONDYLITIS WHAT HAPPENS? <ul><li>Inflammation at joints. </li></ul><ul><li>Stiffness </li></ul><ul><li>Scar ti...
ANKYLOSING SPONDYLITIS
ANKYLOSING SPONDYLITIS TREATMENT <ul><li>Pain relief by drugs. </li></ul><ul><li>Exercise most important. </li></ul><ul><l...
GOUT <ul><li>Deposition of uric acid crystals in joints. </li></ul><ul><li>Uric acid is end-product of protein metabolism....
GOUT <ul><li>Acute attacks triggered by very high protein meals and alcohol. </li></ul><ul><li>Severe pain and redness see...
GOUT WHAT HAPPENS?
GOUT
GOUT TREATMENT <ul><li>Colchicine is taken in acute phase. </li></ul><ul><li>Pain relievers except aspirin can be used. </...
MISSCELLANEOUS  <ul><li>Mainly idiopathic secondary to other diseases. </li></ul><ul><li>Usually associated with skin and ...
MISSCELLANEOUS TREATMENT <ul><li>Treatment of the skin and gastro-intestinal problem. </li></ul><ul><li>Pain relief drugs....
JUVENILE RHEUMATOID ARTHRITIS <ul><li>Almost similar to RA auto-immune. </li></ul><ul><li>Polyarticular or oligo-articular...
PHYSIOTHERAPY AND OCCUPATIONAL THERAPY <ul><li>Major role in the management of arthritic patient. </li></ul><ul><li>Static...
From:   Samvar   Mavani Date:  10/09/05 11:10:41 To:   'A C  mavani ' ;  ' Shail   Mavani ' Cc:   [email_address] ;  Sanja...
ALLOPATHY OR THE REST <ul><li>From white coat view to a balanced view. </li></ul><ul><li>Allopathy not curative but effect...
ACUPUNCTURE ACUPRESSURE <ul><li>Chinese origin pain reliever. </li></ul><ul><li>Balances ying and yang forces. </li></ul><...
AROMATHERAPY <ul><li>Originates from Egypt adopted in Ayurveda and other systems. </li></ul><ul><li>Oils used for massage....
CHIROPRACTIC OSTEOPATHY OR BONE SETTER <ul><li>Ancient system Hippocratic time. </li></ul><ul><li>Relies on manipulation o...
MASSAGE <ul><li>Indian origin. </li></ul><ul><li>Relaxes and soothes. </li></ul><ul><li>Increases blood and lymphatic flow...
REIKI <ul><li>Japanese technique Rei spiritual Ki force </li></ul><ul><li>Hand touch to harmonize energy channels. </li></...
YOGA <ul><li>India’s gift to the West. </li></ul><ul><li>Asanas or postures as means to healing. </li></ul><ul><li>Holisti...
YOGA
AYURVEDA <ul><li>From India based on Charaka samahita. </li></ul><ul><li>Kerela popular destination for oil massages. </li...
HOMEOPATHY <ul><li>Based on Samuel Hahnemann’s principles. </li></ul><ul><li>Dilution increases potency. </li></ul><ul><li...
NATUROPATHY <ul><li>Popularized by Mahatma Gandhi in this century. </li></ul><ul><li>Use of element mud packs sitz baths e...
NUTRITION THERAPY ANJU VENKAT IS THE BOSS
MISCELLANEOUS THERAPIES <ul><li>Psycho-analysis and counselling. </li></ul><ul><li>Hypnotherapy. </li></ul><ul><li>Hydroth...
FINAL WINNER THERAPY PRAY TO THE ALMIGHTY LORD!!!
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  • Arthritis A White Coat View

    1. 1. ARTHRITIS A WHITE COAT VIEW DR. VISPI JOKHI ORTHOPEDIC SURGEON
    2. 2. WHAT IS ARTHRITIS? <ul><li>Arthritis means inflammation of a joint. </li></ul><ul><li>Synonymous terms are rheumatism </li></ul><ul><li>spondylitis osteoarthritis. </li></ul>
    3. 3. NORMAL JOINT
    4. 4. TYPES OF ARTHRITIS <ul><li>Over 200 types are known but the main ones are: </li></ul><ul><li>Osteoarthritis. </li></ul><ul><li>Secondary Osteoarthritis </li></ul><ul><li>Rheumatoid Arthritis. </li></ul><ul><li>Ankylosing Spondylitis. </li></ul><ul><li>Gout. </li></ul><ul><li>Miscellaneous SLE PML UC Amoebiasis etc. </li></ul><ul><li>Juvenile Rheumatoid Arthritis. </li></ul>
    5. 5. PRIMARY OSTEOARTHROSIS <ul><li>Arthritis of ageing. </li></ul><ul><li>Load bearing joints involved. </li></ul><ul><li>Mostly affects knee in east but hip in the west and also hands and feet. </li></ul><ul><li>Pain not always proportionate to degeneration. </li></ul>
    6. 6. OSTEOARTHRITIS WHAT HAPPENS?
    7. 7. OSTEOARTHRITIS
    8. 8. OSTEOARTHRITIS HOW TO TREAT? <ul><li>Drugs only for pain relief. </li></ul><ul><li>Exercises static range of movement and resistance. </li></ul><ul><li>Aerobics word of caution. </li></ul><ul><li>Weight loss. </li></ul><ul><li>Glucosamine Chondroitin sulphate and MSM dubious role. </li></ul><ul><li>Surgery arthroscopic debridement and replacement. </li></ul>
    9. 9. OSTEOARTHRITIS
    10. 10. SECONDARY OSTEOARTHROSIS <ul><li>Post traumatic,post infective or following osteonecrosis. </li></ul><ul><li>End stage arthritis. </li></ul><ul><li>Exercises and weight loss compensates for damage and deformity. </li></ul><ul><li>Finally surgery is the only answer. </li></ul>
    11. 11. RHEUMATOID ARTHRITIS <ul><li>Probably auto-immune disorder. </li></ul><ul><li>Polyarticular small joint affectation followed by the larger ones. </li></ul><ul><li>Pauci-articular with few large joints involved. </li></ul><ul><li>Remissions and exacerbations with systemic disease. </li></ul>
    12. 12. RHEUMATOID ARTHRITIS <ul><li>Under the weather a myth with no scientific basis. </li></ul><ul><li>“ Khatta” in fact good for cartilage. </li></ul>
    13. 13. RHEUMATOID ARTHRITIS WHAT HAPPENS?
    14. 14. RHEUMATOID ARTHRITIS
    15. 15. RHEUMATOID ARTHRITIS TREATMENT <ul><li>Drugs for symptomatic relief and disease modification. </li></ul><ul><li>Exercises to prevent stiffness and preserve range of motion. </li></ul><ul><li>Deformity prevention by judicious splintage. </li></ul><ul><li>Lifestyle modification. </li></ul><ul><li>Diet has a role but not well defined by allopathy. </li></ul>
    16. 16. RHEUMATOID ARTHRITIS TREATMENT <ul><li>Inverted Pyramid approach. </li></ul><ul><li>Disease modifying drugs toxic but effective and need to be taken for long duration. </li></ul><ul><li>Surgery synovectomy, deformity correction and finally replacement of joint. </li></ul>
    17. 17. ANKYLOSING SPONDYLITIS <ul><li>Definitely auto-immune disorder. </li></ul><ul><li>Starts from back bone followed by spine shoulder hip and others. </li></ul><ul><li>Stiffening the defining feature. </li></ul><ul><li>Bamboo spine and reduced chest expansion extremely disabling. </li></ul>
    18. 18. ANKYLOSING SPONDYLITIS WHAT HAPPENS? <ul><li>Inflammation at joints. </li></ul><ul><li>Stiffness </li></ul><ul><li>Scar tissue in front of vertebrae. </li></ul><ul><li>Finally fusion. </li></ul>
    19. 19. ANKYLOSING SPONDYLITIS
    20. 20. ANKYLOSING SPONDYLITIS TREATMENT <ul><li>Pain relief by drugs. </li></ul><ul><li>Exercise most important. </li></ul><ul><li>Exercise regime halts progression of disease. </li></ul><ul><li>Range of motion resistance very important. </li></ul>
    21. 21. GOUT <ul><li>Deposition of uric acid crystals in joints. </li></ul><ul><li>Uric acid is end-product of protein metabolism. </li></ul><ul><li>Diet directly related to gout. </li></ul><ul><li>Great toe joint of foot most commonly involved followed by ankle knee hand wrist and elbow joint </li></ul>
    22. 22. GOUT <ul><li>Acute attacks triggered by very high protein meals and alcohol. </li></ul><ul><li>Severe pain and redness seen. </li></ul><ul><li>Chronic gouty tophi deposited in joints and soft tissues. </li></ul>
    23. 23. GOUT WHAT HAPPENS?
    24. 24. GOUT
    25. 25. GOUT TREATMENT <ul><li>Colchicine is taken in acute phase. </li></ul><ul><li>Pain relievers except aspirin can be used. </li></ul><ul><li>Diet restrictions for red meat alcohol pulses seeded fruits and vegetables. </li></ul><ul><li>Drugs to excrete uric acid used. </li></ul>
    26. 26. MISSCELLANEOUS <ul><li>Mainly idiopathic secondary to other diseases. </li></ul><ul><li>Usually associated with skin and eye lesions like lupus psoriasis and iritis. </li></ul><ul><li>Also associated often with gastro-intestinal disturbances. </li></ul><ul><li>Could be auto-immune. </li></ul><ul><li>Spine affected in most cases. </li></ul>
    27. 27. MISSCELLANEOUS TREATMENT <ul><li>Treatment of the skin and gastro-intestinal problem. </li></ul><ul><li>Pain relief drugs. </li></ul><ul><li>Steroids and disease modifying drugs as in Rheumatoid Arthritis </li></ul>
    28. 28. JUVENILE RHEUMATOID ARTHRITIS <ul><li>Almost similar to RA auto-immune. </li></ul><ul><li>Polyarticular or oligo-articular. </li></ul><ul><li>Less common in India than in the West. </li></ul>
    29. 29. PHYSIOTHERAPY AND OCCUPATIONAL THERAPY <ul><li>Major role in the management of arthritic patient. </li></ul><ul><li>Static, Range of Motion and Resistance or strengthening all have a role to play. </li></ul><ul><li>Re-education of patient movements to improve function. </li></ul>
    30. 30. From: Samvar Mavani Date: 10/09/05 11:10:41 To: 'A C mavani ' ; ' Shail Mavani ' Cc: [email_address] ; Sanjay Thakker Subject: Spine Care...                Attachments Preview: spine_care1.jpg                                                                                                                                                                                                                                                                             
    31. 31. ALLOPATHY OR THE REST <ul><li>From white coat view to a balanced view. </li></ul><ul><li>Allopathy not curative but effective and with side effects. </li></ul><ul><li>Many alternatives available, effective but not on their own. </li></ul><ul><li>Answer Allopathy and the rest. </li></ul>
    32. 32. ACUPUNCTURE ACUPRESSURE <ul><li>Chinese origin pain reliever. </li></ul><ul><li>Balances ying and yang forces. </li></ul><ul><li>Acts by “pain gate” closure. </li></ul><ul><li>No real effect on arthritis. </li></ul>
    33. 33. AROMATHERAPY <ul><li>Originates from Egypt adopted in Ayurveda and other systems. </li></ul><ul><li>Oils used for massage. </li></ul><ul><li>Have anti-inflammatory effects. </li></ul>
    34. 34. CHIROPRACTIC OSTEOPATHY OR BONE SETTER <ul><li>Ancient system Hippocratic time. </li></ul><ul><li>Relies on manipulation of joints. </li></ul><ul><li>Not to be used in the acute phase. </li></ul>
    35. 35. MASSAGE <ul><li>Indian origin. </li></ul><ul><li>Relaxes and soothes. </li></ul><ul><li>Increases blood and lymphatic flow. </li></ul><ul><li>Alleviates pain. </li></ul><ul><li>Can damage if done vigorously. </li></ul>
    36. 36. REIKI <ul><li>Japanese technique Rei spiritual Ki force </li></ul><ul><li>Hand touch to harmonize energy channels. </li></ul><ul><li>Popular but non-specific. </li></ul>
    37. 37. YOGA <ul><li>India’s gift to the West. </li></ul><ul><li>Asanas or postures as means to healing. </li></ul><ul><li>Holistic and very useful in Ankylosing spondylitis. </li></ul>
    38. 38. YOGA
    39. 39. AYURVEDA <ul><li>From India based on Charaka samahita. </li></ul><ul><li>Kerela popular destination for oil massages. </li></ul><ul><li>Negative publicity due to use of toxic heavy metals. </li></ul>
    40. 40. HOMEOPATHY <ul><li>Based on Samuel Hahnemann’s principles. </li></ul><ul><li>Dilution increases potency. </li></ul><ul><li>Treatment fully individualized. </li></ul><ul><li>Holistic in approach, </li></ul><ul><li>Slow in showing effect. </li></ul><ul><li>Negligible side effects. </li></ul>
    41. 41. NATUROPATHY <ul><li>Popularized by Mahatma Gandhi in this century. </li></ul><ul><li>Use of element mud packs sitz baths enemas. </li></ul><ul><li>Nutrition and detoxification important </li></ul>
    42. 42. NUTRITION THERAPY ANJU VENKAT IS THE BOSS
    43. 43. MISCELLANEOUS THERAPIES <ul><li>Psycho-analysis and counselling. </li></ul><ul><li>Hypnotherapy. </li></ul><ul><li>Hydrotherapy. </li></ul><ul><li>Music Therapy. </li></ul><ul><li>Spiritual Healing. </li></ul><ul><li>Meditation. </li></ul>
    44. 44. FINAL WINNER THERAPY PRAY TO THE ALMIGHTY LORD!!!
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