Types of Musculoskeketal and Joint Diseases | Prepforprereg

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Types of Musculoskleletal and Joint Diseases
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Osteoarthritis

• What is Osteoarthritis ?
• A type of joint disease that normally affects the
  large weight-bearing joints of the knees, hips
  and spine although smaller joints such as those
  in the fingers and neck may also be affected.
• In osetoarthritis the cartilage loses its
  elasticity and becomes stiffer.
• The changes negatively impact on the ability of
  cartilage to act as a shock absorber which in
  turn can decrease functionality of the joint.
• Sometimes the cartilage in the joint can be
  broken down resulting in bone ends rubbing
  together and causing significant pain.

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• Symptoms of osteoarthritis
• Pain in the affected joint that is usually worse
  when moving the joint
• Abnormal growths at affected joints
• Inflammation or swelling at affected joints
• Reduced mobility of affected joint
• Stiffness in the joint that is normally worst in
  the morning
• Treatment
• No cure for osteoarthritis
• Appropriate exercise - Undertake exercises that
  will strengthen muscles around joint whilst
  minimising impact cartilage degradation
• Pain relief - Simple analgesics (e.g.
  paracetamol) and non-steroidal anti-inflammatory
  drugs should be considered first line for
  treatment of pain and inflammation.

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Rheumatoid Arthritis

• What is Rheumatoid Arthritis ?
• An autoimmune disease that primarily affects the
  joints
• Immune system mistakenly attacks tissues of the
  synovium causing inflammation and thickening
  resulting in damage to cartilage, tendons,
  ligaments and bone
• Normally affects joints of wrist and hands
• Symptoms of rheumatoid arthritis
• Swollen and painful joints
• Stiffness in joints
• Swelling, warmth and redness of tissues around
  the joints
• Lethargy
• Lack of appetite
• Weight loss
• Fever

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• Treatment
• Disease modifying anti-rheumatic drugs (DMARDs) -
  Includes methotrexate, leflunomide, sulfasalazine
  and hydroxychloroquine
• Biologic agents -  include infliximab amd
  adalimumab
• Important Considerations about Methotrexate -
• Also used in the treatment of Crohn's disease and
  malignant disease
• Methotrexate is usually initiated at a dose of
  7.5mg once weekly
• Dose is then adjusted according to response up to
  a maximum of 25mg once weekly
• Folic acid 5mg may also be taken once weekly on a
  different day to methotrexate to minimise
  incidence of side effects

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Gout

• What is Gout ?
• A form of arthritis characterised by severe
  pain, redness and tenderness in joints. Gout is
  usually characterized by recurrent attacks
  of inflammatory arthritisa red, tender, hot,
  and swollen joint. Pain typically comes on
  rapidly in less than twelve hours. The joint at
  the base of the big toe is affected in about half
  of cases.
• What causes Gout ?
• Increased levels of uric acid in the blood
• Crystals may spill over from the joint cartilage
  and cause inflammation of the surrounding tissues
• Crystals may also clump together and continue to
  grow over time (which are referred to as tophi),
  ultimately leading to the irreversible damage to
  the joint
• Leads to formation of sodium urate crystals
  inside and around the joints

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• Symptoms of Gout
• Sudden, severe pain in the joints usually
  accompanied by significant swelling and
  tenderness around the area
• The big toe is the most commonly affected joint
• There may also be shiny red skin around the area
  which may peel.
• Symptoms usually last up to 10 days
• Treatment
• Relieve symptoms of a gout attack using high
  doses of NSAIDs e.g. diclofenac, etoricoxib,
  indometacin etc. If NSAIDs are contra-indicated
  or poorly tolerated then colchicine should be
  considered. Aspirin should be avoided in gout as
  it increases uric acid levels in the blood.
• Prevention of gout attacks usually involves
  allopurinol or febuxostat (only if allopurinol is
  contra-indicated or poorly tolerated).
  Allopurinol should not be used for the treatment
  of an acute attack of gout.

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