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Thursday, 24 December 2015

Most Common Disease of Elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: The Diagnosis

Kyle J. Norton (Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia



                       Osteoarthritis


Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).


                            The Diagnosis 

The aim of the diagnosis is to differentiate the diseases against other types of arthritis to avoid misdiagnosis and to rule out the other (secondary osteoarthritis)causes of osteoarthritis (OA)(104).
After taking the complex physical examination and careful exam the physical symptoms such as, joint swelling, Joint tenderness, decreased range of motion in joints, Visible joint damage, etc. some of the below tests may be necessary.
1. Blood Test
Although blood test is not necessary in many cases of osteoarthritis (OA), it can be helpful tool to rule other causes of the disease, including rheumatoid arthritis as it will indicate an inflammatory process(erythrocyte sedimentation rate (ESR, or sed rate) such as the presence of anti-cyclic citrullinate d peptide (anti-CCP) antibodies(105).

2. Synovial fluid analysis
Synovial fluid analysis is the test to exam the joint synovial fluid for conditions involving joint inflammation, pain, swelling, and fluid accumulation(106). Abnormal joint fluid may comprise abnormal amounts of detrimental bioactive proteins, temporary clearance, dilution or suppression/modulation as an indication of inflammation or osteoarthritis(107).
3. X-rays
X rays beside is one of the common used to diagnosed for findings of osteoarthritis (OA) such as abnormal joints, bone, joint space between adjacent bone, loss of joint cartilage, etc., Accordning to the Framingham study, according to radio graphics, the prevalence of meniscus damage in the knee of subjects with no, one to two, and three or more finger joints with OA was 24.9%, 31.7%, and 47.2%, respectively. X-rays can show damage, other changes associated to osteoarthritis and to confirm the diagnosis(108)

4. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is a more sensitive imaging method, it is used less often than x-rays due to cost and availability. In conjunction of X ray for Osteoarthritis (OA), MRI has been used increasingly in recent years through a meta-analysis of published studies, according to Tufts University, School of Medicine(109) MRI scans show cartilage loss, damage and defects, bone size, bone marrow lesions, bone expansion and damage to ligaments(110).

5. Etc.

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You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

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References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(104) Osteoarthritis Diagnosis(Spine health)
(105)The Pathogenesis of Rheumatoid Arthritis: Pivotal Cytokines Involved in Bone Degradation and Inflammation by CLIFTON O. BINGHAM III(The Journal of Rheumatology)
(106) Biologic basis of osteoarthritis: state of the evidence. by Malemud CJ1.(PubMed)
(107) Diverse expression of selected cytokines and proteinases in synovial fluid obtained from osteoarthritic and healthy human knee joints by Sauerschnig M1,2, Stolberg-Stolberg J3, Schulze A4, Salzmann GM5, Perka C6, Dynybil CJ7.(PubMed)
(108) Osteoarthritis Diagnosis(Arthritis foundation)
(109) The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis. by Menashe L1, Hirko K, Losina E, Kloppenburg M, Zhang W, Li L, Hunter DJ.(PubMed)
(110) How important is MRI for detecting early osteoarthritis? by Changhai Ding*, Flavia Cicuttini and Graeme Jones(Natrue Clinical Pratctice Rheumatology)