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  1. 1. Arthritis <ul><li>Arthritis = inflammation of the joints. Term also used by lay people to describe pain in soft tissues. </li></ul><ul><li>Over 200 forms of arthritis. </li></ul><ul><li>About 30% of adults have arthritis. </li></ul><ul><li>Major symptom = in or around joints </li></ul>PAIN
  2. 2. Risk Factors for Arthritis <ul><li>Age > 40 years </li></ul><ul><li>Women > men </li></ul><ul><li>Obesity </li></ul><ul><li>Previous joint injury </li></ul><ul><li>Ethnic background </li></ul>
  3. 3. Osteoarthritis <ul><li>Your mother, who is overweight, has pain in both knees whenever she walks too far. Her knees are stiff in the morning and hurt before it rains. The pain gets better when she rests or takes acetaminophen, ibuprofen, or naprosyn over the counter. Her knees are big, bony, and sometimes swollen, but don’t get red or warm. </li></ul>
  4. 4. Osteoarthritis <ul><li>21 million Americans have osteoarthritis </li></ul><ul><li>Breakdown in cartilage and new bone formation </li></ul><ul><li>Increased risk with older age, obesity, overuse or previous injury to joints </li></ul>
  5. 5. Osteoarthritis <ul><li>Common spots of osteoarthritis </li></ul><ul><ul><li>hips </li></ul></ul><ul><ul><li>knees </li></ul></ul><ul><ul><li>hands, especially base of thumb </li></ul></ul><ul><ul><li>base of great toe </li></ul></ul><ul><ul><li>spine </li></ul></ul><ul><li>What is not osteoarthritis? Red, hot joints </li></ul>
  6. 6. Osteoarthritis <ul><li>Treatment </li></ul><ul><ul><li>weight reduction </li></ul></ul><ul><ul><li>exercise </li></ul></ul><ul><ul><li>physical and occupational therapy </li></ul></ul><ul><ul><li>joint protection </li></ul></ul><ul><ul><li>pain relief </li></ul></ul><ul><ul><ul><li>over the counter medications, esp. acetaminophen </li></ul></ul></ul><ul><ul><ul><li>prescription medications </li></ul></ul></ul><ul><ul><ul><li>joint injections </li></ul></ul></ul><ul><ul><li>joint replacement </li></ul></ul>
  7. 7. Gout <ul><li>Your brother, who has high blood pressure, woke up in the middle of the night with excruciating pain in his right great toe. It hurt so bad he could not stand to have the sheet rest on his foot last night; he couldn’t sleep. The joint at the base of the toe is red, hot, swollen and very tender . His other joints are OK. He had an episode just like this 5 months ago, and it went away by itself, over 5-7 days. </li></ul>
  8. 8. Gout <ul><li>Gout is caused by too much uric acid in the body. Crystals of uric acid form inside a joint and cause inflammation, which makes the joint red, hot, swollen and painful . </li></ul><ul><ul><li>runs in families </li></ul></ul><ul><ul><li>more common in men, women after menopause, and African Americans. </li></ul></ul><ul><ul><li>Other risk factors include </li></ul></ul><ul><ul><ul><li>obesity </li></ul></ul></ul><ul><ul><ul><li>high blood pressure </li></ul></ul></ul><ul><ul><ul><li>drinking too much alcohol </li></ul></ul></ul><ul><ul><ul><li>kidney failure </li></ul></ul></ul><ul><ul><ul><li>water pills </li></ul></ul></ul>
  9. 9. Gout <ul><li>Treatment: See a doctor for evaluation and medicine to reduce inflammation and pain. May need to medicine to prevent future attacks. </li></ul><ul><li>Can develop into chronic arthritis and cause joint destruction. </li></ul>
  10. 10. Tendonitis <ul><li>Your son just spent two weeks painting his house. Now, his shoulders hurt whenever he reaches overhead, even to put on a shirt. He has never had any shoulder pain before and his other joints are fine. </li></ul>
  11. 11. Tendonitis <ul><li>Diagnosis = shoulder tendonitis. Tendonitis = inflammation of a tendon. A tendon is a tissue cord that holds a muscle onto a bone. </li></ul><ul><li>Treatments </li></ul><ul><ul><li>reduce/stop doing whatever caused it </li></ul></ul><ul><ul><li>non-steroidal anti-inflammatory agents </li></ul></ul><ul><ul><li>steroid injections </li></ul></ul><ul><ul><li>physical therapy – splinting, heat, ice </li></ul></ul>
  12. 12. Bursitis <ul><li>Bursitis = inflammation of a bursa. A bursa is a sac that lays over bony projections, to reduce friction as tissue rubs over the bone. </li></ul><ul><li>Common sites of bursitis </li></ul><ul><ul><li>outer shoulder area </li></ul></ul><ul><ul><li>outer hip area </li></ul></ul><ul><ul><li>elbow </li></ul></ul><ul><ul><li>over and below the knee cap </li></ul></ul>
  13. 13. Serious types of arthritis <ul><li>Lupus (systemic lupus erythematosus) </li></ul><ul><li>Rheumatoid arthritis </li></ul><ul><li>Scleroderma </li></ul><ul><li>Sjogren’s syndome </li></ul><ul><li>Lyme disease </li></ul><ul><li>Ankylosing spondylitis </li></ul><ul><li>Psoriatic arthritis </li></ul><ul><li>Infectious arthritis </li></ul>
  14. 14. When to see a doctor for arthritis <ul><li>Joint is red, hot or very painful . </li></ul><ul><li>Other symptoms such as fever, tiredness, weight loss, rash, skin thickening, hair loss, ulcers in the nose or mouth or on the fingers, cold sensitivity in the hands, swollen fingers or toes, muscle weakness, numbness or tingling. </li></ul><ul><li>Pain persists despite over the counter medication. </li></ul>