Arthritis And Other Pain Syndrome

Hip and Knee

                       ARTHRITIS

   ●                  Types of arthritis

    ●        Symptoms of arthritis

    ●        Signs of arthritis

    ●        Treatment of arthritis

  TYPES OF ARTHRITIS

        ●       Rheumatoid arthritis (RA)

        ●       Osteoarthritis (OA)

        ●       Sero-negative arthritis

  

        ●       Ankylosing spondylitis

        ●       Reiter’s disease

        ●       Crystal arthropathies

   RHEUMATOID ARTHRITIS

           ●       affects 3% population

          ●       female> male (3:1)

          ●       80% RF

          ●       30% ANF

          ●       HLA DR4 (chr 6)

RHEUMATOID ARTHRITIS  PATHOLOGY

•       Synovitis

                       chronic infl, synovial hypertrophy, effusion

•      Destruction

                 proteolytic enzymes, pannus

•       Deformity

            articular destruction, capsular stretching, tendon rupture

RHEUMATOID ARTHRITIS EXTRA-ARTICULAR

●       nodules

●       tendon sheath

●       vasculitis

●       myopathy and neuropathy

●       reticulo-endothelial system

●       visceral - lungs, heart, kidneys, brain, GI

RHEUMATOID ARTHRITIS EARLY SYMPTOMS

●      myopathy, tiredness, weight loss, malaise

●       proximal finger joints

●       wrists, feet, knees, shoulders

●       start up pain

●       tendon crepitus

RHEUMATOID ARTHRITIS EARLY JOINT CHANGES

RHEUMATOID ARTHRITIS LATE SYMPTOMS

 ●       joint destruction

●       pain

●       deformity

●       instability

RHEUMATOID ARTHRITIS ADVANCED JOINT CHANGES

RHEUMATOID ARTHRITIS X-RAY FINDINGS

●       joint space narrowing

●       peri-articular osteopenia

●       erosions

RHEUMATOID ARTHRITIS TREATMENT

●       stop synovitis

●       prevent deformity

●       reconstruct

●       rehabilitate

RHEUMATOID ARTHRITIS PROGNOSIS

●       10% improve

●       60% intermittent, slowly worsening

●       20% severe joint erosion, multiple surgery

●       10% completely disabled

OSTEOARTHRITIS

A chronic joint disorder in which there is progressive softening and disintegration of articular cartilage accompanied by new growth of cartilage and bone at the joint margins (osteophytes) and capsular fibrosis

OSTEOARTHRITIS CLASSIFICATION

●      Primary or idiopathic

●      Secondary - infection

-       dysplasia

-       Perthes’

-       SUFE

-       trauma

-       AVN

OSTEOARTHRITIS AETIOLOGY

●       Genetic

●       metabolic

●       hormonal

●       mechanical

●       ageing

OSTEOARTHRITIS X-RAY CHANGES

●       joint space narrowing

●       subchondral sclerosis

●       osteophytes

●       cysts

ARTHRITIS SYMPTOMS

 ●       pain

●       swelling

●       stiffness

●       deformity

●       instability

●       loss of function

ARTHRITIS NON-SURGICAL TREATMENT

●       analgesia

●       disease modifying drugs (RA)

●       altered activity

●       walking aids

●       physiotherapy

ARTHRITIS SURGICAL TREATMENT

●       arthroscopy

●       osteotomy

●       arthrodesis

●       excision arthroplasty

●       replacement arthroplasty