Arthritis

Ryan Carr
Serafina Morada-Angulo
Maurice Smith
Bio 54
Monday-Wednesday
What is Arthritis?
Arthritis is joint inflammation and a chronic illness.

It is the nation’s most common cause of disability.

Treatments for Arthritis:
Non-inflammatory types are usually treated with pain
medications, physical activity, weight loss (if
overweight), and self-management education.
Inflammatory types are treated with these modalities as
well as anti-inflammatory medications (corticosteroids
and non-steroidal anti-inflammatory drugs (NSAIDs)),
disease modifying anti-rheumatic drugs (DMARDs), and a
relatively new class of drugs known as biologic agents.
Who Can Help?
Arthritis Foundation:

a) It is the only nationwide, nonprofit health organization

helping people take greater control of arthritis.

b)The main mission is to improve lives through leadership

in the prevention, control and cure of arthritis and
related diseases.
Osteoarthritis (OA)

What is OA?

a) It is medically called osteoarthroses or degenerative

joint disease.
b)It is the most common type of arthritis.
c) It is also a chronic condition characterized by the
breakdown of the joint’s cartilage.
 Cartilage is the part of the joint that cushions the end
of the bones and allows easy movement of joints. The
breakdown of cartilage causes the bones to rub against
each other, causing stiffness, pain and loss of
movement in the joint.
Causes of OA:
The causes are not known yet, but possible factors
include the following:
a) Heredity
b) Overweight
c) Joint injury
d) Repeated overuse of certain joints
e) Lack of physical activity
f) Nerve injury
g) Aging
Related Symptoms:
Pain or stiffness in joints after periods of inactivity or
excessive use.
Granting or “catching” sensation during joint
movement.
Bony growths at the margins of affected joints.
How OA is Diagnosed:
Typically based on medical history and examination.

With joint damage, some doctors recommend x-ray or

MRI’s to double check that it is another cause.
Joint aspirations, a procedure in which fluid is drained
from the affected joints and examined, and blood tests
also may be used to rule out other forms of arthritis in
the body.
Affects Are:
 Typically only certain joints, such as the hips, hands, knees,
low back and neck.

 After age 50, women are more affected than men.

 Costs:
a) Arthritis and related conditions, such as OA, costs the U.S.
economy nearly $128 billion per year in medical care and
indirect expenses, including lost wages and productivity.
b) The total annual cost of OA per person living with OA is
approximately $5700
c) The average direct cost of OA is approximately $2,600 per
year per person living with OA.
Prevention:
Losing as few as 11 pounds can cut risk of developing
knee osteoarthritis.
Physical activity keeps joints flexible and maintains or
improves muscle strength.
Joint protection prevents stress on painful joints.

Weight loss of only 15 pounds can cut knee pain in half

for overweight individuals with arthritis.
Treatment:
Depends on severity of symptoms.

Focuses on decreasing pain & improving joint

movement.
Often include a combination of drugs, rest physical
activity, use of heat or cold to reduce pain.
Corticosteroids or hyaluricacid derivatives can be
injected into joints unresponsive to treatment.
Surgery is an important consideration in people with
advanced OA.
Who can help?
Osteoarthritis alliance
a) Is a community of people sharing a personal and
common interest in realizing a world free of arthritis.
b) It’s mission is to share information, inspiration and
camaraderie with one another.
Rheumatoid Arthritis (RA)
What is RA?
a) It is a chronic disease, mainly characterized by
inflammation of the lining, or synovia, of the joints.
b) It can lead to long-term joint damage, resulting in
chronic pain, loss of function and disability.

http://www.youtube.com/watch?v=ae4ZdRfZR3I
Three Stages of RA:
① Swelling of the synovial lining, causing pain, warmth,
stiffness, redness and swelling around the joint.

② Rapid division and growth of cells, or pannus, which

causes the synovia to thicken.

③ The inflamed cells release enzymes that may digest

bone and cartilage, often causing the involved joint to
lose its shape and alignment, more pain, and loss of
movement.
Rheumatoid Arthritis (RA):
It is a chronic disease that may not go away, which
frequent flares can occur.
It is a systematic disease that can effect other organs in
the body.
RA serves as an autoimmune disease.
a) The body has an abnormal immune system response.

Early diagnosis and treatment is critical to limit joint

damage, which in turn limits loss of movement,
decreased ability to work, higher medical costs and
potential surgery.
Rheumatoid Arthritis
(Continued):
There is no cure for it.
a) Research and treatment have helped patients live
healthier, happier lives
b) It is easier than ever to control RA through the use of
new drugs, exercise, joint protection techniques and
self- management techniques. While there is no good
time to have rheumatoid arthritis, advancements in
research and drug development mean that more people
with RA are living happier, healthier and fulfilling lives.
Causes of RA:
The causes are unknown.

In a healthy immune system, white blood cells produce

antibodies that protect the body against foreign
substances. People who have RA have an immune
system that mistakes the body’s healthy tissue for a
foreign invader and attacks it.
Rheumatoid Factor:
 It is an antibody that is directly to regulate normal antibodies
made by the body.
 Works well in people with small quantities of rheumatoid factor.
People with high levels of rheumatoid factor, however, may have
a malfunctioning immune system.
 The higher the level of rheumatoid factor present in the body,
the more sever the disease activity is.
 It is important to note that all people with RA have an
elevated rheumatoid factor test and not all people with an
elevated rheumatoid factor have RA.
a) Approximately 20 percent of people with RA will have a negative
rheumatoid factor test and some people who do not have RA will
test positive.
Gender:
Gender might play a role in the development and
progression of RA.
Men tend to be more severely effected when they DO
get it.
Women…
a) Get RA two to three times more often than men.
b) Develop RA more often than expected in the year after
pregnancy and symptoms can increase after a baby is
born.
c) Researchers are trying to understand the effects female
hormones might have in development RA.
Genes:
Most researchers believe there are genes involved in the
cause of RA.
a) The specific genetic marker associated with RA, HLA-
DR4, is found in more than 2/3 of Caucasians with RA
while it is only found in 20 percent of the general
population. While people with this marker have an
increased risk of developing RA, it is not a diagnostic
tool. Many people who have the marker either do not
have or will never get RA. While this marker can be
passed from parent to child, it is not definite that if you
have RA, your child will too.
Infection:
Some physicians and scientists believe that RA is
triggered by a kind of infection. There is currently no
proof of this.
a) Rheumatoid arthritis is not contagious, although it is
possible that a germ to which almost everyone is
exposed may cause an abnormal reaction from the
immune system in people who already carry a
susceptibility for RA.
Symptoms:
How is RA diagnosed:
No quick test

Made from medical history, physical exams, lab tests

(complete blood count, erythrocyte sedimentation rate
aka ESR/Sed Rate)
Affects are:
Can range from person to person.

Can start in any joint, but in most commonly begins in

the smaller joints of fingers hands and wrist.
Joint involvement is usually symmetrical, meaning that
if a joint hurts on the left the same will hurt on the
right as well.
Advanced changes to look out for include damage to
cartilage and and deformity.
Prevention:
Self-Management

Exercise – improve sense of well-being

Activity and rest balance – “use it or lose it, “

listen to your body
Stress – reduction optimistic perception and control

Depression – recognize these feelings

Relaxation and sleep – deal with stress

Who is at risk?
It can affect anyone including children

People with genetic marker – found in WBC which

distinguishes between its own and foreign invaders
70% of women

Between the ages of 30-50 years

Pregnant women
a) Often goes into remission
b) Symptoms increase after giving birth
Treatment:
It is crucial that you get an early diagnosis and work
with your doctor to find best treatment
Improvement of available medications

Surgery
a) Synovectomy
b) Arthroscopic surgery
c) Osteotomy
d) Joint replacement surgery
e) Arthrodesis/Fusion
Medications:
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Analgesic drugs

Glucocorticods or prednisone

 disease Modifying Antirheumatic Drugs (DMARDs)

Arthritis in Women:
 Different types:

 Osteoarthritis
 Of the nearly 27 million Americans who have osteoarthritis,
approximately 16 million are women.

 Rheumatoid Arthritis
 Usually strikes women between the ages of 25 to 50
 Approximately 1.3 million American adults have RA, with women
outnumbering men 2.5 to 1

 Fiber myalgia
 An estimated 3.7 million Americans have fibromyalgia; the figure may
actually be higher since some of its symptoms may be found in other
conditions such as chronic fatigue syndrome (which is also more
common in women).
Arthritis in Women (Continued):
 Lupus
 Almost 240,000 Americans– 90% of whom are women.
 It usually affects women of childbearing age.

 Osteoporosis
 It affects approximately 28 million Americans; four of
every five people affected are women.
 Postmenopausal women and those with small or then
frame, a family of history of osteoporosis and habit such as
smoking and drinking are at a higher risk of osteoporosis.
Women Living with Arthritis:
During pregnancy:
a) Women with arthritis have entirely healthy pregnancies
in spite of their positions.

Women with arthritis may notice changes in their

disease during pregnancy.
a) Women with RA often have some improvement in their
arthritis during pregnancy, but the arthritis may worsen
(flare) after the baby is born.
Treatment for Women:
Exercise

Keeping a calm pace

Staying in contact with your doctor

Fibromyalgia:
Fibromyalgia means that there is pain in the muscles,
ligaments and tendons.
Systemic Lupus Erythematous:
Two Types:
① Discoid Lupus (skin only)
② Drug-Induced lupus (temporary)

Lupus is a prototype autoimmune disease with a wide

array of clinical manifestations
 Rash, photosensitivity, oral ulcers, arthritis, pleuritis,
pericarditis, kidney problems, seizures and psychosis,
and blood cell abnormalities.

Primarily a disease of young women

Juvenile Arthritis (JA):
About 300,000 children in the united states have a form
of JA
 Children are also affected by arthritis as a part of many
other diseases

Autoimmune disease
 Causes are
1. Unknown
2. Genetic variation from family members combined with
 Symptoms are
1. Inflammation – warmth, swelling, redness
Diagnosis:
Physical exam, medical history

X-rays, CT, MRI

Lab tests
Different Types:
Three schemes: juvenile rheumatoid arthritis (JRA),
juvenile chronic arthritis (JCA), Juvenile idiopathic
arthritis (JIA)
Juvenile Dermatomyostis (JDMS)
 Affects 3,000 to 5,000 children in the U.S.
Juvenile idiopathic arthritis (JIA)
 Most common forms of arthritis in children

Juvenile Spondyloarthopathies (jSp)

 Some types of arthritis involve the spine as well as
tendons, especially where tendons attach to bone
Treatment:
The goals are any treatment program are to control
inflammation, relieve pain, and prevent joint damage
Childs treatment program will include medications,
exercise, eye care, and proper nutrition
Surgery, although rare, may be necessary to treat
special long-term problems
History of Arthritis:
 Arthritis dates back to prehistoric time, and was referred to
being the most common ailment of prehistoric peoples.
 The first known trace of human form of arthritis dates back
to 4500 BC.
 In 1591, French physician and Dean of the University of Paris
medical factory, Guillaume de Baillou, wrote the first book
on arthritis.
 In 1680, treatment for RA was being done with Peruvian bark.
 In 1763, treatment for RA was then changed to Willow bark.
 It wasn’t till 1859 that the disease was given a name by Sir
Alfred Garrod.
History of Arthritis (Continued):
 In 1893, a surgeon named W.A. Lane developed a system of
carbon steel screws and plates that made internal repair of
bones and joints possible.
 In 1897, the Bayer Company took the Willow bark treatment a
step further, manufacturing acetylsalicylic acid, better
known as aspirin.
 In 1929, another new drug emerges; periodic injections of
gold salts are first used to relieve muscle pain.
 In 1939, Sir McFarlane Burnet bought the autoimmune theory
into discussion.
 In 1948 Drs. Philip Hench and E.C. Kendall discover the
therapeutic anti-inflammatory effects of steroid hormones.
Recent Findings:
Managing depression and getting a good amount of sleep
can help one take control of arthritis.
Diet does play a role in the possibility of getting
diagnosed with arthritis.
Currently, scientists are focusing on altering
biomechanical properties of cartilage cells.
 Ideally, they want to find a mechanism that could reliably
stimulate cartilage replacement.
Thank You for your time!