Recurrent Breast Cancer

Thursday, July 11, 2013


            Osteoarthritis (OA) is a condition of gradual loss of joint cartilage. It is the most common type of joint disease, and affects more than twenty million people in the U.S.. More than fifty percent of adults older than sixty five have OA. 

Risk factors for OA include advancing age, family history of OA, and overweight.
OA is more common in whites than in blacks for people over sixty five. However, knee osteoarthritis appears more common in black women than in other groups. 

Symptoms often begin after age fifty. Likelihood of arthritis is higher in women than men who are older than fifty five. Women are more likely to have finger and knee OA compared to men. 

Symptoms include deep joint pain worsened with use, limited joint motion, and morning stiffness. OA predominantly involves weight-bearing joints, including knees, hips, lower spine, and feet.
People with OA become less active and gain weight over time. However, over the counter medicines and rest relieve pain.

X-rays show narrowed joint space. Bone scans, ultrasound, and MRIs (Magnetic Resonance Imaging) are usually not indicated unless there is joint infection or suspected tumor. A sample of fluid from the affected join can confirm diagnosis. As OA progresses, joint cartilage softens and loses elasticity. This leads to joint space narrowing. 

Treatment goals include alleviating pain and improving function. Heat and cold packs, weight loss, exercise, and physical therapy decrease discomfort and improve balance. Sometimes knee and hip braces are prescribed. 

Prescription medicines for OA include Capsaicin (Zostrix) cream, patch, or lotion. Tramadol (Ultram), an opiate-like drug, alleviates pain. Its side effects include constipation, nausea, and sleepiness.   

Helpful over the counter medicines include Advil, Aleve, and Tylenol.
Cortisone and visco-supplementation (artificial joint fluid) injections to the knees and hips relieve pain and inflammation. 

If the above treatments fail to improve function, then surgery (arthroscopy, osteotomy, arthroplasty) is considered.  

People with knee and hip OA who have joint replacement surgery have a success rate more than ninety percent. 

 Younger and more active people might need repeat surgery ten to fifteen years later, depending on their activity level. Physically ambitious people are more likely to need revision surgery, but the majority of older people don’t. 

 “Unless you try to do something beyond what you have already mastered, you will never grow.”
                                                                                    Ralph Waldo Emerson. `

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