INFLAMMATION & DEGENERATION ARTHRITIS

DEFINITIONS

INFLAMMATORY JOINT DISEASE IS SYSTEMIC, CAUSES STIFFNESS ALL OVER, SWELLING IN JOINTS, PAIN AND FATIGUE

DEGENERATIVE JOINT DISEASE CAUSES PAIN WITH MINIMAL STIFFNESS AND SWELLING AND NO FATIGUE

DIFFERENCE

STIFFNESS IS FAR GREATER IN INFLAMMATORY ARTHRITIS THAN DEGENERATIVE AND SO IS THE FATIGUE/WEAKNESS

ETIOLOGY

INFLAMMATORY IS AUTOIMMUNE (RA, LUPUS), CRYSTAL INDUCED (GOUT), INFECTIOUS, METABOLIC (THYROID,PARATHYROID)

DEGENERATIVE IS GENETIC, END RESULT OF INFLAMMATORY, TRAUMA, AGE...

CASE - 1

80 YEAR OLD WITH MODERATELY SEVERE BACK PAIN AFTER WALKING LESS THAN A MILE,

SHE ALSO IS STIFF IN HANDS FOR 45 MIN IN AM

CASE - 2

45 YO WITH GENERALIZED SEVERE PAIN, IN ALL JOINTS AND STIFFNESS THAT LASTS FOR

HRS. AFTER TREATMENT HER DEVELOPED INCREASING LEFT HIP PAIN THAT IS PROGRESSIVELY GETTING WORSE.

TREATMENT

HISTORY AND PHYSICAL

LAB

X-RAY/MRI

TREATMENT

PHYSICAL THERAPY

AQUA-THERAPY

FISH OIL/GLUCOSAMINE

EXERCISE

TOPICAL APPLICATIONS

TREATMENT

GLUTEN FREE

MSG, ALFALFA SPROUTS

MEAT, SEA FOOD, BBQ,

COOKED TOMATOES AND EGGPLANTS

ALCOHOL- BEER VERSUS OTHERS

TREATMENT

NSAIDs

DISEASE MODIFYING DRUGS-NON BIOLOGICS

DISEASE MODIFYING DRUGS-BIOLOGICS

RESEARCH

TREATMENT

NON BIOLOGICS EXAMPLES: MTX, SULFA, LEFLUNOMIDE, PLAQUENIL (HCQ), AZATHIOPRINE, CELLCEPT...

TREATMENT

TNF BIOLOGICS: ENBREL, HUMIRA, REMICADE, CIMZIA, SIMPONI, ARIA

TREATMENT

NON-TNF: ORENCIA, RITUXAN, ACTEMRA, BENLYSTA, XELJANZ,

TREATMENT

HIGH RISK MEDS: EDUCATE, SCREEN, VACCINE, HYGENE