1. Objectives Define arthritis List risk factors
Distinguish between osteoarthritis, gout, tendonitis and bursitis in disease origin
List common types of serious arthritis

2. Arthritis
Arthritis = inflammation of the joints. Term also used by lay people to describe pain in soft tissues.
Over 200 forms of arthritis.
About 30% of adults have arthritis.
Major symptom = in or around joints
PAIN

3. Risk Factors for Arthritis
Age > 40 years
Women > men
Obesity
Previous joint injury

4. Osteoarthritis
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.

5. Osteoarthritis 21 million Americans have osteoarthritis
Breakdown in cartilage and new bone formation
Increased risk with older age, obesity, overuse or previous injury to joints

6. Osteoarthritis Common spots of osteoarthritis hips knees
hands, especially base of thumb
base of great toe
spine
What is not osteoarthritis? Red, hot joints

7. Osteoarthritis

8. Osteoarthritis Treatment weight reduction exercise
physical and occupational therapy
joint protection
pain relief
over the counter medications, esp. acetaminophen
prescription medications
joint injections
joint replacement

9. Gout
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.

10. Gout
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.
runs in families
more common in men, women after menopause, and African Americans.
Other risk factors include
obesity
high blood pressure
drinking too much alcohol
kidney failure
water pills

11. Gout
Treatment: See a doctor for evaluation and medicine to reduce inflammation and pain. May need to medicine to prevent future attacks.
Can develop into chronic arthritis and cause joint destruction.

12. Tendonitis
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.

13. Tendonitis
Diagnosis = shoulder tendonitis. Tendonitis = inflammation of a tendon. A tendon is a tissue cord that holds a muscle onto a bone.
Treatments
reduce/stop doing whatever caused it
non-steroidal anti-inflammatory agents
steroid injections
physical therapy – splinting, heat, ice

14. Bursitis
Bursitis = inflammation of a bursa. A bursa is a sac that lays over bony projections, to reduce friction as tissue rubs over the bone.
Common sites of bursitis
outer shoulder area
outer hip area
elbow
over and below the knee cap

15. Serious types of arthritis
Lupus (systemic lupus erythematosus)
Rheumatoid arthritis
Scleroderma
Sjogren’s syndome
Lyme disease
Ankylosing spondylitis
Psoriatic arthritis
Infectious arthritis

16. When to see a doctor for arthritis
Joint is red, hot or very painful.
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.
Pain persists despite over the counter medication.