2. DEFINITION
• Rheumatology is a subspecialty in internal
medicine
• Study of joints, soft tissues, autoimmune
diseases and heritable connective tissue
disorders.
3. OSTEOARTHRITIS
• Osteoarthritis is the most common form of
arthritis
• Affecting millions of people worldwide.
• It occurs when the protective cartilage that
cushions the ends of the bones wears down
over time.
6. SYMPTOMS
• The main symptoms of osteoarthritis are pain
and sometimes stiffness in the affected joints.
• The pain tends to be worse when you move
the joint or at the end of the day.
• Your joints may feel stiff after rest, but this
usually wears off fairly quickly once you get
moving.
7.
8. DIAGNOSIS
• Generally by history and examination
• tenderness over the joint
• creaking or grating of the joint – known as crepitus
• bony swelling
• excess fluid
• restricted movement
• joint instability
• weakness or thinning of the muscles that support the
joint.
11. RHEUMATOID ARTHRITIS
• Rheumatoid arthritis, or RA, is an
autoimmune and inflammatory disease
• your immune system attacks healthy cells in
your body by mistake, causing inflammation
(painful swelling) in the affected parts of the
body.
• RA mainly attacks the joints, usually many
joints at once.
12. • Mostly involved both large and small joints
• sometimes affects other parts of your body, including
your:
• Skin.
• Eyes.
• Mouth.
• Lungs.
• Heart.
13. AGE OF ONSET
• RA usually starts to develop between the ages
of 30 and 60.
14. SYMPTOMS
• Pain, swelling, stiffness and tenderness in more
than one joint.
• Stiffness, especially in the morning or after sitting
for long periods.
• Pain and stiffness in the same joints on both sides
of your body.
• Fatigue (extreme tiredness).
• Weakness.
• Fever.
16. INVESTIGATION
• Erythrocyte sedimentation rate (ESR).
• C-reactive protein (CRP).
• About 80% of people with RA test positive for
rheumatoid factor (RF).
• About 60% to 70% of people living with
rheumatoid arthritis have antibodies to cyclic
citrullinated peptides (CCP) (proteins).
17. • X RAY
• Ultrasounds
• Magnetic resonance imaging (MRI) scans.
21. CONNECTIVE TISSUE DISEASE
• A connective tissue disease is any disease that
affects the parts of the body that connect the
structures of the body together.
• Connective tissues are made up of two
proteins: collagen and elastin
• When a patient has a connective tissue
disease, the collagen and elastin are inflamed.
22. TYPES
• There are more than 200 different types of
connective tissue diseases.
• They may be inherited, caused by
environmental factors, or most often, are of
unknown cause.
23. • Churg-Strauss Syndrome: A type of autoimmune
vasculitis that affects cells in the blood vessels of
the lungs, gastrointestinal system, skin and
nerves.
• Systemic Lupus Erythematosus (SLE): A disease
that can cause inflammation of the connective
tissue in every organ of the body, from the brain,
skin, blood, kidneys and lungs etc. It’s nine times
more common in women than in men
24. • Rheumatoid Arthritis (RA)
• Scleroderma: An autoimmune condition that
causes scar tissue to form in the skin, internal
organs (including the GI tract), and small blood
vessels.
• Granulomatosis with Polyangiitis (GPA, formerly
called Wegener’s): A form of vasculitis
(inflammation of the blood vessels) that affects
the nose, lungs, kidneys and other organs.
25. • Microscopic Polyangiitis (MPA): An
autoimmune disease that affects cells in blood
vessels in organs throughout the body. This is
a rare condition.
• Polymyositis/dermatomyositis: A disease
characterized by inflammation and
degeneration of the muscles. When the
condition also affects the skin, it’s called
dermatomyositis.
26. • Mixed connective tissue disease (MCTD), also
called the Sharp syndrome: A condition that
has some, but not all, features of various
connective tissue diseases, such as SLE,
scleroderma, and polymyositis. MCTD may
also have features of Raynaud’s syndrome.
27. CAUSES
• Toxic Chemicals
• Air Pollution
• Cigarette smoke.
• Exposure to ultraviolet light.
• Inadequate nutrition, including lack of
vitamins D and C.
• Infections.
30. ARTHRITIS IN ELDERLY
Effects of Arthritis on the Elderly
• Arthritis care is not easy, whether you are the person
suffering or you are the caregiver for someone who
struggles with arthritis.
• Being in any sort of pain make anyone miserable.
• Arthritis can lead to a loss of mobility, which in turn
can lead to a loss of a feeling of independence.
• Many seniors suffer depression.
• It is a disease that takes a physical and mental toll on a
person.
31. HOW TO MANAGE
• Ensure medications are being taken.
• Encourage a healthy diet.
• excessive weight can put added strain on joints
and worsen arthritis pain.
• Exercise together. There are several low impact
exercises that can help alleviate arthritis pain,
such as yoga, and swimming.
• Consider day to day living. Take note of “simple”
tasks that are no longer simple for your loved one
with arthritis, like opening jars or gripping and
moving things from a high shelf.
32. • Hot and cold treatments.
• Acupuncture and massage can provide temporary
relief to particularly stiff joints.
• Yoga and meditation can help you relax and ease
your pain.
• Exercise, including stretching, range of motion
movement, and strength training for the muscles
around the joints can be particularly helpful
• Maintain good posture when seated and keep
moving.
33. ARTHRITIS IN CHILDREN
• The most common type of childhood arthritis
is juvenile idiopathic arthritis (JIA), also
known as juvenile rheumatoid arthritis.
• the most common type of arthritis in children
under the age of 16.
37. PSEUDOGOUT (CPPD)
• Calcium pyrophosphate dihydrate crystal
deposition disease (CPPD) is a form of
arthritis that causes pain, stiffness,
tenderness, redness, warmth and swelling
(inflammation) in some joints.
38. • CPPD commonly affects the knee or wrist.
• CPPD affects both men and women.
• It occurs more frequently in people as they
are over age 60.
39. RISK FACTORS
• A thyroid condition.
• · Kidney failure.
• · Parathyroid disease.
• · Low magnesium.
• · Disorders that affect calcium, phosphate or
iron metabolism (such as hemochromatosis).
42. GOUT
• Gout is a painful form of arthritis.
• When your body has extra uric acid, sharp
crystals may form in the big toe or other
joints, causing episodes of swelling and pain
called gout attacks.
43. • Obesity
• Congestive heart failure.
• Diabetes.
• Family history of gout.
• Hypertension (high blood pressure).
• Kidney disease.
• DIURETICS
• HIGH PROTEIN
• ALCOHOL
RISK FACTORS
44. • JOINT FLUID ASPIRATION
• Gout crystals are shaped like a needle and
are negatively birefringent.
• XRAYS
• CT
INVESTIGATION
46. PREVENTION
• Drink plenty of water
• Exercise regularly to stay at a healthy weight.
• AVOID Foods containing high purine levels include:
• Alcohol.
• Red meat and organ meats (liver, for example).
• Shellfish.
• Gravy.
• Drinks and foods high in fructose (fruit sugar).
• Protein from animal sources. All protein from animal
flesh can potentially lead to elevated uric acid levels.
47. SPONDYLOARTHROPATHY
• Spondyloarthropathies are forms
of arthritis that usually strike the bones in
your spine and nearby joints.
• They are characterized by inflammation of the
spine, sacroiliac (SI) joints, peripheral joints,
enthesitis, dactylitis, as well as extra-articular
manifestations such as uveitis and skin rashes
48. • Serologically, they are rheumatoid factor (RF)
and antinuclear antibody (ANA) negative.
• Genetically, they are associated with human
haplotype antigen, HLA-B27, which suggests a
common pathologic mechanism.
49. What Are the Types?
• ankylosing spondylitis
• It attacks joints between the bones that make up your
spine (vertebrae). But there are other forms as well
• Reactive arthritis often develops after an infection in
the urinary tract or digestive system. It tends to attack
joints in the lower limbs.
• Reiter’s syndrome is a type of reactive arthritis that
happens as a reaction to an infection in another part of
your body. It can include redness, joint swelling and
pain, often in knees, ankles, and feet.
50. • Psoriatic arthritis affects major joints of the body,
as well as the fingers and toes, along with the
back and pelvis. It typically happens to people
who have a skin condition called psoriasis or who
have family members with psoriasis.
• Enteropathic spondyloarthropathy. People who
have a digestive tract illness like Crohn’s disease
sometimes get this condition. About 1 in 5 people
who suffer from Crohn’s or ulcerative colitis will
get this form of spondyloarthropathy.
