What your joints need

Multiple studies have demonstrated that early aggressive management of rheumatoid arthritis (RA) is beneficial.

What many patients don’t understand is why this is so important. Beyond the pain, stiffness, and inability to perform activities of daily living, moist patients aren’t aware of the other insidious dangers that rheumatoid arthritis- if not optimally managed- poses.

The very substances- called cytokines- that promote the chronic inflammation of joints are also responsible for more serious problems affecting internal organs. Examples of some of these cytokines are TNF-alpha, interleukin-1 (IL-1), and IL-6.

These cytokines lead to insulin resistance, abnormal function of cells that line blood vessels, and abnormalities of cholesterol metabolism, causing increases in total cholesterol, low density lipoproteins (LDL- “bad cholesterol”), and triglycerides. The end result is a marked tendency to atherogenesis- “hardening of the arteries”.

This hardening of the arteries is associated with cardiovascular disease leading to a marked tendency to stroke and heart attack. The insulin resistance also contributes to other metabolic disturbances. These metabolic problems can be aggravated by the natural tendency for patients with poorly controlled RA to be subject to stress, poor dietary habits, and less than sufficient exercise. The bottom line is that the life expectancy of a patient with rheumatoid arthritis is shortened by ten to fifteen years compared with age-matched controls.

One study demonstrated a two-fold higher risk for coronary heart disease in patients with rheumatoid arthritis compared with people who did not have rheumatoid arthritis (Satter N, McInnes IB. Curr Opin Rheumatol. 2005; 17: 286-292).

Another study showed that women with rheumatoid arthritis who had had rheumatoid arthritis for at least ten years were three times more likely to have had a heart attack compared to women without RA (Solomon DH, Karlson EW, Rimm EB, et al. Circulation. 2003; 107: 1303-1307).

So… it is this important but little emphasized complication of the disease that must be emphasized to patients.

Fortunately, most of the data that has been accumulated related to the cardiovascular issues from RA were collected before the advent of biologic therapy. There is increasing evidence that aggressive management of RA employing the newer biologic agents can help reduce the increased cardiovascular complications related to RA. One example is a study showing that female patients with RA treated with TNF-inhibitors had a reduced overall mortality rate. Unfortunately, the same was not true for men in this one example (Jacobsson LT, Turesson C, Nilsson JA, et al. Ann Rheum Dis. 2007; 66: 670-675).

However other studies have demonstrated a lower rate of cardiovascular problems such as heart attack, stroke, and congestive heart failure) in patients with RA treated with TNF-inhibitors (Dixon WG, Watson KD, Lunt M, et al. Arthritis Rheum. 2007; 56: 2905-2912).

So what should the approach be?

There is still a great deal of ignorance among patients with rheumatoid arthritis regarding the above mentioned complications. Currently, many patients are under the misimpression that natural remedies are good and that drugs are to be avoided, condemned, and are all-in-all, bad. What a mistake!

What rheumatologists must do is explain the reasoning behind the need for aggressive management. It should be explained that there is a narrow “window of opportunity” that makes treatment critical.

Patients should be educated as to the pathophysiology of RA and the terrible consequences that may arise as a result of less than optimal therapy.

While an open mind toward natural therapies is important, an open mind towards the value of proper medical therapies is just as critical.

It is particularly important that patients and physicians become strategic allies together to combat this medical scourge. The aim should be to induce complete remission.

Arthritis, an inflammation of bone joints, is generally characterized as an illness affecting people over the age of 50, so it can come as a great surprise to parents when their children are diagnosed with some form of it. What may be even more surprising is that roughly 300,000 children in the United States alone have arthritis, and the public is largely unaware of this fact.

The most common form of arthritis affecting children is named juvenile rheumatoid arthritis, affecting about 20% of those 300,000 children, and all parents should be educated on this debilitating disease in children. Doctors are not yet entirely sure what causes juvenile rheumatoid arthritis, but they believe that it is linked to autoimmune diseases, where white blood cells are unable to differentiate between normal and foreign cells.

The Familiar Symptoms

If a child has juvenile rheumatoid arthritis, parents may immediately begin to notice a limp or other signs of soreness among joints. While not uncommon among children by itself, other symptoms may include rashes and spiking fevers. If any of these symptoms occur for an extended length of time, a doctor should be consulted. The faster the diagnosis, the less damage will occur to cartilage and the joints affected by juvenile rheumatoid arthritis.

Diagnosis

Juvenile rheumatoid arthritis is easily diagnosed through a wide array of tests, not all of which need to be performed (although at least several likely will be). Diagnostic tools include blood tests, X-rays, and complete physical examinations. Also, tests for other diseases linked to juvenile rheumatoid arthritis may be performed, in addition to referral to an orthopedic surgeon to take samples of joint fluid for testing and further analysis.

A diagnosis usually takes several days. Once the test come back the pediatrician or doctor will work together with the orthopedic surgeon and any other medical professionals to develop a strategy to cure the child of juvenile rheumatoid arthritis.

Easily Treatable

The good news for parents is that juvenile rheumatoid arthritis is easy to treat. Doctors can prescribe medication to help with the swelling and inflammation and referral to a physical therapist. Physical therapists generally point out exercises to improve the arthritis and improve muscle stamina and joint flexibility. Also, regular exercise is vital to ensuring that the child is protected against further arthritis by protecting bones and joints. Treatment serves two purposes: to protect and repair the joints from damage while reducing or eliminating the inflammation and pain.

Juvenile rheumatoid arthritis can be an unsettling concept for parents, and it can make a child’s life miserable. This disease can harm their social skills and make them irritable while hindering their physical development. However, through a quick diagnosis and easy treatment, parents can ensure that their children will never be harmed by juvenile rheumatoid arthritis.

It’s no fun getting a diagnosis of rheumatoid arthritis. But perhaps you haven’t yet received the diagnosis. Perhaps you are afraid of ever getting rheumatoid arthritis. There are a lot of illnesses and aliments that abound in life that can cause a great amount of pain. One of the most common conditions that most human beings are sentenced to is some form of arthritis. Even children can get juvenile rheumatoid arthritis.

Prevention

Although most people do get a form of joint inflammation at some point during their lives, you don’t have to be certain that you are doomed to get any kind of arthritis, including rheumatoid arthritis. By eating a sensible diet to keep an ideal body weight and exercising regularly, you are already making a great contribution to reducing your chances of getting rheumatoid arthritis, or getting a less painful form of it.

Quitting smoking is another way of helping to reduce your chance of getting rheumatoid arthritis, or a severe form of it. Smoking reduces your circulation, which means you don’t get the proper blood flow to all parts of your body. When your circulation system is under stress (as it usually is for a smoker), then it concentrates on just keeping the inner organs functioning. It then conserves energy for this by shutting off circulation to your fingers and toes.

Never Stop Moving

Even if you get the dread diagnosis, it doesn’t mean your life is over. There are far worse medical conditions to be diagnosed with other than rheumatoid arthritis. However, you probably grew up seeing your elderly relatives and neighbors suffer from it. This can leave a very strong impression in your subconscious.

So, even though you know some other diseases and illnesses are worse, you probably never had the direct contact as you did with someone suffering from rheumatoid arthritis. You saw what happened to them and you don’t want it to happen to you. Recognize your fear and give it a name. Call it “arthritis-it is” is you want. Make up a silly name for it and write it down. Looking at the small word can help you realize that it’s only a small fear.

There are a lot more effective treatments for rheumatoid arthritis now than there was when you first saw someone suffer from inflamed, stiff joints. Since everybody’s rheumatoid arthritis is different, there are many different treatments to choose from. Many people find it best to combine conventional medicine with alternative treatments, such as acupuncture.

Arthritis is an ailment which involves a number of painful conditions of the joints and the bones. There are a number of different types of this disease. Most types are inflammatory while others are degenerative in nature.

The disease may be preceded or coupled by an episode of fatigue and feeling of weakness. The pains in the joints most of the time starts in the hands, particularly in the knuckles. Most of the time, the pain are felt in both hands simultaneously, as in the case of one of the most typical form called rheumatoid arthritis.

Other usual forms of arthritis include osteoarthritis, gout arthritis, ankylosing spondylitis arthritis, juvenile arthritis, psoriatic arthritis, systemic lupus erythematosus and septic arthritis.

Other forms of arthritis can emerge as a result of an infection. For instance, bacteria causing gonorrhea or Lyme disease can also lead to arthritis. Arthritis that are caused by infection can cause serious injuries, but generally clears up completely with the use of antibiotics.

Scleroderma, a systemic ailment which involves the skin, may incorporate harms with the blood vessels, internal organs as well as the joints. Another disease called fibromyalgia syndrome is soft-tissue rheumatism that does not usually result to the deformation of the joints but affects an estimated number of 5 million Americans which are mostly women. Over 100 various types of arthritis and arthritis related conditions have been reported.

In making a diagnosis, there are a number of common symptoms of arthritis that have to be considered. These common symptoms of arthritis can be found in tandem with different forms of arthritis. A person may likely to have arthritis if they have been experiencing any of these common symptoms of arthritis such as persistent joint pains, unexplainable weight loss or non-specific fever.

Joint deformities, inflammation as indicated by joint swelling, redness, stiffness and/or warmth, loss of range of movement or flexibility in a joint, extreme fatigue and lack of energy are also some of the common symptoms of arthritis.

Due to the fact that there are a lot of existing types of arthritis, there are many tests that are being performed for arthritis and its related diseases. Your medical doctor will be in charge of ordering tests basing on your comprehensive listing of symptoms. Some of the tests and procedures that may help diagnose arthritis include online self-assessments, such as self-assessment for candidiasis and the magnesium deficiency assessment. This self-testing procedure can aid you in determining the root causes of your persistent conditions.

There are also certain saliva tests which can make you check if you have an acid alkaline imbalance. According to recent studies, the reduction on the levels of acidity in the body can have a good effect on improving the common symptoms of arthritis.

Blood tests can also be done. Patients who suffer with arthritis have inflammatory markers found in their blood. These tests may include checking for the presence of positive rheumatoid factor, presence of citrullinated peptide or CCP antibody, checking the erythrocyte sedimentation rate (ESR) and checking for the levels of C-reactive protein or CRP.

Septic arthritis is an inflammation of a joint caused by a bacteria infection other than gonorrhea. It may also occur when the joint is directly infected with bacteria during injury or surgery. Septic arthritis can occur at any age. When considering children, it occurs at a higher rate in those under 3 years of age, with the hip, knee and ankle being the most common joints affected. Septic arthritis may affect any joint but is most frequently found in the knee, hip, shoulder, wrist, elbow, and finger joints. Approximately 20,000 cases of suppurative arthritis occur in the United States each year. From age 3 to adolescence, Septic arthritis is uncommon, at which point incidence will increase again. Septic arthritis is often seen in the elderly, immunosuppressed and those with chronic inflammatory arthritides.

The onset of the symptoms is usually rapid with joint swelling, intense joint pain, and low-grade fever. Septic arthritis in the hip may be experienced as pain in the groin area that becomes much worse if the patient tries to walk. In the majority of cases, there is some leakage of tissue fluid into the affected joint. Risk factors for Septic arthritis include a simultaneous bacterial infection, chronic illness, diseases or medications that operate on suppression of the immune system, intravenous drug abuse, rheumatoid arthritis, sickle cell disease, artificial joints, recent damage to a joint leading to bruising/inflammation, or recent joint arthroscopy or other invasive surgery. Septic arthritis should be suspected when one joint (monoarthritis) is affected and the patient is febrile.

Septic arthritis must be diagnosed quickly and treated with antibiotics. The antibibiotics are continued orally (usually two antibiotics for six weeks and then one for a further six weeks). In immunosuppressed, gentamicin and flucloxacillin is used Rest, immobilization, elevation, and warm compresses may help relieve pain. Performing exercises for the affected joint aids the recovery process. Prophylactic (preventive) antibiotics may be helpful for high-risk people. Empirical Antibiotics – Discuss with microbiologist. Intravenous flucloxacillin and fusidic acid for at least a week. Drainage of the joint and arthroscopic washouts are helpful in relieving pain. Immobilize joint and then physiotherapy started earlyu to prevent stiffness and muscle wasting.

Septic Arthritis Treatment Tips

1. Antibiotics are used to treat the infection.

2. Rest, immobilization, elevation, and warm compresses may help relieve pain.

3. Prophylactic (preventive) antibiotics may be helpful for high-risk people.

4. Fluid is usually aspirated from the affected joint to relieve pressure.

5. Aspiration may need to be done several times to relieve pressure.

Rheumatoid arthritis affects 1.3 million Americans. Research advances and drug development have helped control this chronic disease. Noted UCLA Rheumatology expert Dr. Michael Weisman, presents an update on the latest treatments in the second of two lectures. Series: The Coming of Age Lecture Series [7/2008] [Health and Medicine] [Show ID: 14861]