Osteoarthritis

A joint disease resulting from breakdown of the protective cartilage at the ends of bones.

Injury or wear and tear can lead to permanent changes to the joint structure.

One bone may rub against the other and bony growths may develop. The joint may produce more synovial fluid in an attempt to cushion the joint, but this can cause swelling and reduce movement.

Risk factors: Obesity increases strain on joints, age, family history, being a women (especially post menopause) and previous injury.

Symptoms

NICE guideline: 45 and older, and don't experience morning joint stiffness for 30 minutes or experience joint pain

Pain, stiffness, tenderness, grating swelling and bone spurs

Rheumatoid Arthritis

Causes

Affects less than 1% of the population

An autoimmune disease where the immune system attacks synovial cells lining the joint capsule, inflammation releases chemicals that damage the bones, cartilage, tendons and ligaments. Joint may lose shape or be destroyed

Risk factors: family history of the disease, being a women and smoking.

Symptoms

Joint pain and stiffness may be more severe in mornings

Affects any joint, but usually starts in hands or feet

Redness, heat, fever, fatigue and weight loss

Monitoring

Blood tests to check for inflammation and rule out other causes

X-rays and MRI check for structural changes

Monitoring

Can be diagnosed without tests if meet NICE guideline

Blood tests rule out other causes

X-rays asses joint damage but not severity

Osteoporosis

Causes

A malfunction of the skeletal system in which bone becomes less dense and therefore weaker.

The osteoblast cells (create new bone) become less active than the osteoclast cells (break down bone). Bone is being removed faster than it is being replaced

Risk factors: female, post menopause, low calcium, family history, excessive alcohol, anorexia, low vitamin D, lack of exercise, smoking, old age, Asian or Caucasasian, low estrogen or testosterone

Symptoms

Few symptoms

Easily fractured or broken bones

Possible loss in height, spinal curve and back pain if spine affected

Monitoring

DEXA bone scan

Blood tests

Check mineral and hormone levels

X-ray passed through bobe. Level of absorption shows bone density

Quick, painless, accurate, lower radiation than standard x-ray

Not suitable for pregnant

Lifestyle changes

Lose weight if overweight

High calcium and vitamin D intake

Weight bearing exercises

Physiotherapy or resistance training

Stop smoking

Medication

Bisophosphonate

Slows bone break down. Effective, but takes 6-12 months to work

SERMs

Mimics oestrogen, encourages bone density

HRT

Treats symptoms of menopause. Increases bone density, but has risks of cancer and blood clots

Treatments

Lifestyle adjustments

Medication: DMARDS, steroids, pain relief

Physio/exercise

Surgery

Assistive tech

Lifestyle adjustment

Comfortable shoes

Pacing activities

Maintain healthy weight