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Kenneth D. Kleist, M.D. HealthPartners Medical Group Regions Hospital St. Paul, MN Arthritis 101.

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Presentation on theme: "Kenneth D. Kleist, M.D. HealthPartners Medical Group Regions Hospital St. Paul, MN Arthritis 101."— Presentation transcript:

1 Kenneth D. Kleist, M.D. HealthPartners Medical Group Regions Hospital St. Paul, MN Arthritis 101

2 The Key Players Orthopaedic Surgeon –The expert in the musculoskeletal system –Diagnose –Treat Medication Physical Therapy Exercise Brace Surgery –Prevent Physician Assistant Primary Care Sports Medicine Physician Physical Therapist

3 ArthritisBackground Arthritis is the second most common chronic condition in the US (sinusitis is first) –Most common among elderly Arthritis affects over 20 million people in the US –76 million by 2030 Leading cause of disability in people > 65 yo Total costs associated with arthritis are over $82B/year, including hospital and drug costs, nursing home costs, and lost productivity and work

4 Bone Fibrous capsule Joint space filled with synovial fluid Articular cartilage Synovial membrane Synovial Joints

5 There are two general types of arthritis Osteoarthritis: By far the most common –Garden Variety or wear and tear –Caused by the breakdown of cartilage –Remainder of the talk will focus here Rheumatoid Arthritis and related diseases: –These involve not only the joints but other organs like skin, tissues, eyes, and blood vessels –Immune system attacks the tissues of the joint

6 Pain Avoidance of Motion Increased Muscle Tightness Loss of Motion Osteoarthritis (Inflammation of Joints)

7 What does arthritis look like Normal Knee X-Ray Arthritic Knee X-Ray

8 Diagnosis: History Symptoms –Pain in affected joints –Pain worse with prolonged overuse –Pain better with rest and exercise –Stiffness relieved by flexing

9 Diagnosis Physical exam X-rays Blood test to rule out other diseases

10 Treatment: Non-operative Activity modification –Avoid painful activities –Low impact exercise Decreases pain Improves flexibility Improves joint nutrition –Physical Therapy –Cane or other assistive device

11 Treatment: Non-operative Weight Control –Maintain current weight or lose weight –10 lbs of weight loss lbs less weight on your hips and knees Heat/Cold – Both Can be effective

12 Treatment: Medication Acetaminophen – Pain control (Tylenol) NSAIDs – Pain and inflammation –Standard Ibuprofen, naproxen, piroxicam –Cox-2 Celecoxib Ultram – Non-narcotic, addiction potential Mild Narcotics –Not recommended except short term

13 Treatment: Injection Corticosteroids (Cortisone) Injection –Anti-inflammatory placed into the joint –Temporary pain relief –Temporary swelling improvement –Does not change the arthritis –Limited number per year –Blood sugar elevation in diabetes

14 Treatment: Injection Hyaluronic Acid Injections (knee only) –A series of 3 – 5 injections –Much more costly than steroids –May last longer than steroids –No one knows exactly how they work May increase lubrication May soothe the nerve endings May have anti-inflammatory effect

15 Treatment: Alternative Approaches No Scientific Evidence to Recommend –Glucosamine/Chondroitin Sulfate –Acupuncture –Green tea –Grape seed extract –Tart cherry concentrate

16 Treatment Summary Activity Modification Weight Management Medications Injections Alternative Treatments

17 Questions??


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