2. Dr. Mahboob Ur Rahman BSPT,PPDPT,EMBA Chief Physiotherapist HMC Peshawar/ Founder &Chairman Mahboob School of Physiotherapy Hayatabad.

3. Arthritis The word arthritis is composed of 2 words These are,“arthr” means joint and“ itis” means inflammation Arthritis can affect babies and children, as well as people in the prime of their lives” Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. There are various types of Arthritis. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

4. Arthritis Types Rheumatoid Arthritis OsteoArthritis Infectious (Septic) Arthritis Juvenile arthritis

5. Osteoarthritis It is a degenerative joint disease. It develops in large & weight bearing joints that are exposed to repeated overuse due to nature of job or sport. Articular cartilage suffers from wear and tear due to repeated use. Eventually the cushion that is provided by cartilage is lost due destruction of the cartilage. As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom of OA is pain that worsens following exercise or immobility

6. OA cont Symptoms: pain in joints, limited Range of Motion, tenderness/swelling, creaking joints, deformity Diagnosis: Physical Exam, X-Rays, Blood Tests Risk Factors: Age, Gender (female), previous joint injuries, obesity, weak thigh muscles (for knee), contracting gout, rheumatoid arthritis, or hemochromatosis Treatment usually includes analgesics, topical creams, or nonsteroidal anti-inflammatory drugs (known as NSAIDs); appropriate exercises or physical therapy; joint splinting; or joint replacement surgery for seriously damaged larger joints, such as the knee or hip.

7. Rheumatoid Arthritis “A chronic autoimmune disease characterized by the inflammation of the synovial joints” Has a symmetrical bilateral effect on joints Results in joint deformity and immobilization Multiple factors increase one’s risk

8. Symptoms Morning stiffness lasting more than half an hour Simultaneous symmetrical joint swelling Not relieved by rest Fever Weight loss Fatigue Anemia Lymph node enlargement Nodules Raynaud’s phenomenon

9. Diagnosis CBC Radiographs of involved joints CT/MRI scans Direct arthroscopy Synovial/Fluid aspirate Synovial membrane biopsy Arthrocentesis ) No single test is specific to Rheumatoid Arthritis

10. X-Ray X-rays are an important diagnostic test for monitoring the disease progression Patients may reveal NO changes on an X-ray in the early stages

11. Management Rheumatoid Arthritis can be managed through medication (NSAIDs, DMARDs, Corticosteroids etc), Physical Therapy, Occupational Therapy, Orthotics.

12. Physiotherapy in Rheumatoid Arthritis

19. Thanks