arthritis slides kyle hackett
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Rheumatoid Arthritis& Osteoarthritis
Arthritis
•Broad range of conditions characterized by inflammation of the joint(s)•Various causes/types
Osteoarthritis (OA), Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis, Septic arthritis, Psoriatic arthritis, Gout, Lupus
•Major complaints Joint pain (often with muscle and tendon aches) Reduced activity
Visualizing The Damage
Joint space narrowing and sclerosis of cartilage can be seen on an x-ray or MRI
OA involves cartilage damage.RA involves synovial inflammation.
Osteoarthritis•Most common form of arthritis
Over 20 million Americans, F>M, 60+•Caused by “wear and tear” on cartilage
Genetics play a role in some cases•Can affect any joint
Usually large, weight-bearing joints & hands•Presents as pain, stiffness, limited range of motion•No cure. Gradually worsens over time.
Osteoarthritis - Treatment
Physical therapy helps improve symptoms by strengthening muscles and connective tissue. Weight loss also helps ease pressure on joints.
Medications such as Acetaminophen (Tylenol®), Glucosamine, and in some cases Naproxen or Ibuprofen can help ease pain if taken properly.
Assistance devices such as canes and walkers can improve balance and relieve fatigue. Joint supports are also helpful in some cases.
Osteoarthritis – Topical Treatment
•Pain rubs – for minor, local pain Capsaicin (chili pepper)
Capzasin Salicylates (aspirin-like)
Aspercreme, Bengay Menthol (cooling)
Icy-Hot, Biofreeze, Bengay•Patches – for minor, local pain
Osteoarthritis – Oral Medicines
•Oral medicines – for moderate/severe pain Tylenol (Acetaminophen) = 1st choice Over the Counter NSAIDs
Ibuprofen (Advil®, Motrin®) Naproxen (Aleve®) Aspirin
Prescription NSAIDs Indomethacin, Piroxicam, Ketoprofen, Celebrex®,
Diclofenac, Nabumetone, and MANY others Other prescriptions
Osteoarthritis – Alternatives
•Glucosamine sulfate Taken by mouth, twice daily, with food A supplement that might help replenish natural
joint lubricants, decrease inflammation, and reduce pain
Symptomatic relief only?•Sodium hyaluronate
Injected into the knee by your doctor Increases the viscosity of the synovial fluid Symptomatic relief only?
Rheumatoid Arthritis
•Systemic Exhaustion, weight loss, muscle pain Auto-immune•Inflammatory, Usually symmetric•Bio-markers present in blood•Can cause deformity•Cause of disease is not clear•Not life-shortening if treated appropriately•Several treatment options are available
Rheumatoid Arthritis - Treatment
•Blood tests, Rheumatologist monitoring•Initial: Anti-inflammatory to help with pain/inflammation•Next step: “Disease-modifying” drugs
Methotrexate, Leflunomide, Azathioprine, etc. Remicade®, Enbrel®, Humira®, etc.•Walking devices, physical therapy, rest, weight reduction, and sometimes surgery
Advanced Rheumatoid Arthritis
Rheumatoid lung diseaseRheumatoid nodules
Thank you for listening!
Any Questions?
Sources•Images from
Arthritislegpain.us (1st image) Emedicine.medscape.com (2nd image) vivajoyhealthclub.wordpress.com (3rd image) Emedicinehealth.com (4th, 5th, 6th, and 7th images) Walkersforseniorsonline.com (8th image) Images.rheumatology.org (9th image) Pulmonarylungdisease.info (10th image) Healthdiet2.com (11th image)•References
Schuna AA. Rheumatoid Arthritis. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, Pharmacotherapy: A Pathophysiologic Approach. 7th ed. McGraw Hill; 2008:1505-1517.
Boyce EG. Rheumatoid Arthritis. In: Helms RA, Quan DJ, Herfindal ET, Gourley DR, Textbook of Therapeutics: Drug and Disease Management. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:1705-1736.
Temprano, K, Diamond HS. Rheumatoid Arthritis. Medscape [online]. Available at: http://emedicine.medscape.com/article/331715-overview. Accessed July 31, 2011.
Aletaha D, Negoi T, et. al. 2010 Rheumatoid Arthritis Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheum. September 2010;62(9):2569-2581.
Anandarajah AP. Clinical aspects of rheumatoid arthritis: highlights from the 2010 ACR conference. Int J Clin Rheumatol. 2011;6(3):267-272.
Clinical Pharmacology [database online]. Tampa, FL: Gold Standard, Inc.; 2011. URL: http://www.clinicalpharmacology-ip.com.ezproxy.mcphs.edu/default.aspx. Updated periodically. Accessed August 2011.
Lexi-Comp OnlineTM , Lexi-Drugs OnlineTM , Hudson, Ohio: Lexi-Comp, Inc.; August 2, 2011.
Micromedex® Healthcare Series [Internet database]. Greenwood Village, Colo: Thomson Reuters (Healthcare) Inc. Updated periodically
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