8
Osteoporosis and Arthritis
Learning Objectives
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Millions of Americans suffer from painful chronic diseases such as osteoporosis and arthritis. Two of the more common forms of arthritis are rheumatoid arthritis and osteoarthritis, which, because of its name, is often confused with osteoporosis.
Osteoporosis and arthritis have different causes and different treatments. In some cases, the treatment for one of these diseases may cause or worsen the other. For example, a common drug used for treatment of one form of arthritis is corticosteroid medications; this medication, when used in high doses, can lead to osteoporosis. Moreover, a program of regular, weight-bearing exercise prescribed for patients with osteoporosis may worsen the condition of an individual with osteoarthritis. It is possible for a person to have more than one of these diseases at the same time.
The information presented here is intended to be used as an aid in discussing these diseases with your physician. Once a diagnosis is made, your physician will develop a treatment plan tailored to your needs.
OSTEOPOROSIS
Osteoporosis (osteo=bone, porosis=porous, i.e., porous bone) is a disease characterized by the exaggerated loss of bone mass and by poor bone quality. Bones become fragile and susceptible to fractures. The consequences of osteoporosis can be devastating: each year this disease leads to more than 1.3 million fractures.
The following are a few essential facts about osteoporosis:
| affects the entire skeleton |
| no warning signs until a fracture occurs, typically at the hip, spine, or wrist |
| more prevalent in postmenopausal, Caucasian and Asian women with small, thin frames |
| risk factors include early menopause, either naturally or surgically induced; family history of osteoporosis; high doses of corticosteroids for asthma, arthritis, cancer; or high doses of thyroid hormones |
| a preventable and treatable disease |
| prevention strategies include a balanced diet rich in calcium, a regular program of weight bearing exercise, and, when necessary, hormone replacement |
| treatment strategies include the above recommendations as well as specific drugs such as estrogen or calcitonin |
| can be detected through the use of non-invasive tests which measure bone density and assist in predicting the risk of fractures; x-rays can only detect bone loss after it is substantial, but are useful in diagnosing fractures |
ARTHRITIS
Arthritis (arth=joint, itis=inflammation) is a condition which affects the joints and surrounding tissue. Osteoarthritis and rheumatoid arthritis are the most common forms of arthritis.
Osteoarthritis
Osteoarthritis is an entirely separate condition from osteoporosis but is sometimes confused with it because of the name. Osteoarthritis is a degenerative joint disease which leads to the thinning or destruction of the cartilage, causing painful irritation of the involved joints and adjacent bone tissue. In certain forms of the disorder, bony growths may occur because of the abnormal rubbing together of the bones.
The following are a few essential facts about osteoarthritis:
| most common form of arthritis |
| most often affects the hip, knees, fingers, feet, or spine |
| affects each joint differently, and symptoms are easy to over- look |
| pain after overuse or prolonged immobility; painful growths in finger joints |
| factors leading to osteoarthritis may be heredity, obesity, and overuse or injury of joints |
| diagnosis based on medical history and physical examination, including x-rays, blood tests, and, in some cases, joint aspiration |
| no known treatment is available to stop or reverse the effects; joint protection, exercise, pain relief medication, heat and cold treatments, weight control, and, when necessary, joint replacement surgery are used to control the effects |
Rheumatoid Arthritis
This is another form of arthritis that is entirely different from ostearthritis. Rheumatoid arthritis is an inflammatory disease of the lining of the joints and is of unknown cause.
The following are a few essential facts about rheumatoid arthritis:
| warning signs are swelling or recurring pain or tenderness in one or more joints; stiffness or inability to move a joint normally, obvious redness or warmth in a joint; unexplained weight loss, fever, or weakness combined with joint pain |
| principal outcomes of arthritis may be joint pain and joint deformity; in severe cases of rheumatoid arthritis, other organ systems or tissues may become involved, and patients may develop inflammation in the eyes, pleurisy, fatigue, weight loss, and anemia |
| diagnosis through blood and urine tests, x-rays, tests of fluid from the joints, and examination of small amounts of joint or muscle tissue |
| not preventable but usually treatable with a combination of exercise, medication rest, and methods of protecting the joints |
| several drugs are used in treating arthritis, including aspirin, non-steroidal anti-inflammatory drugs, and corticosteroids |