Transcript 슬라이드 1
뼈 관절염 Osteoarthritis Kyung Dong University Dept. of Occupational Therapy Kim Chan Mun Aetiology Women Men 53% 37% What is a joint? Joint = Bone + Cartilage + Synovial Fluid The joints hurt! Cartilage cushions joints all over the body. Therefore, any joint has the potential to be affected by osteoarthritis. Pain, stiffness, and inflammation result when cartilage wears away and bones begin to rub together, especially after periods of inactivity or overuse. Hip joint Someone with osteoarthritis in the hips is likely to feel pain in the groin, inner thigh, or outer portion of the hip. Some people feel what is called “referred pain” in the knee or along the side of the thigh. The pain from osteoarthritis in the hip may cause you to limp when walking. OA can maximally affect the superior pole, inferior pole, posterior part or other segments of the hip joint. Superior pole involvement, with a tendency for the head of the femur to sublux superolaterally, is the commonest pattern. knee joints When the knees are affected by osteoarthritis, tenderness in the knee area or pain when bending your knee can occur. Going up or down stairs or rising from a chair may be painful. A patient with typical OA of the knees. In the normal standing posture there is a mild varus angulation of the knee joints due to symmetrical OA of the medial tibiofemoral compartments. OA of the knees can affect any combination of the three main compartments of each knee. It is usually symmetrical, and the compartments most frequently involved are the medial tibiofemoral and patellofemoral compartments. Hands • Osteoarthritis in the hands can cause pain, swelling, and the growth of bone spurs in the finger joints. Osteoarthritis of the DIP joints. This patient has the typical clinical findings of advanced OA of the DIP joints, including large firm swellings (Heberden’s nodes), some of which are tender and red due to associated inflammation of the periarticular tissues as well as the joint. Spine • Osteoarthritis of the spine is caused by a chronic breakdown of the spinal disks, which results in bony growths. • Symptoms of spinal osteoarthritis include pain in the neck, shoulder, arm, lower back and into the legs. • Additionally, someone with osteoarthritis may have stiffness in his/her neck or back, or a feeling of weakness or numbness in his/her arms or legs. Ankle and foot • Osteoarthritis in the feet usually affects the large joint at the base of the big toe. • Symptoms are pain or tenderness around this joint, which is worsened by wearing tight shoes or high heels. Risk factors you cannot change • Several of the currently identified risk factors for osteoarthritis cannot be changed. • One unchangeable risk factor for osteoarthritis is having a family history. • Increasing age is another known risk factor for osteoarthritis that cannot be changed. • Only 7% of adults aged 18 through 44 have arthritis, while this disease affects half (51%) of adults aged 75 and over. Women are more likely to develop osteoarthritis than men. Risk factors you can change • One risk factor that can be changed is overuse of the joint. • Constant, repetitive use of the joints can increase the chances of developing osteoarthritis. • Also, repeated heavy lifting can lead to the development of osteoarthritis. • Significant injury to the body, such as torn ligaments or fracture, can put affected joints at risk of osteoarthritis. • Being overweight or obese places extra stress on the weightbearing joints of the body. • Also, the extra stress on the joints may cause increased pain in the affected joint, limiting your ability to exercise, and resulting in weaker muscles and more weight gain. • Osteoarthritis of the knee is likely to develop, and more likely to progress, if the large muscles in the thigh, also known as the quadriceps, are weak. Exercise is important •Regular exercise is another behavioral change with many health benefits, not just prevention and treatment of osteoarthritis. •Exercise helps to support and stabilize your joints • Strengthening exercises combine light weights with repetitive lifting to keep muscles strong and increase muscle strength where necessary. • When you do aerobic exercise, your large muscles are used rhythmically and continuously, your heart rate and breathing are increased, and you can lose weight. • In relation to osteoarthritis, aerobic exercise helps to reduce pain and improve function of your joints. • Brisk walking or bike riding • Aquatic exercises, such as swimming or water aerobics • Dancing you enjoy with friends. • Stretching or range-of-motion exercises, such as yoga or tai chi, can help prevent joint stiffness as well as improve flexibility, increase muscle strength, and promote relaxation. . Quadriceps exercises for knee OA. Quadriceps exercises are of proven value for pain relief and improving function, and everyone with knee OA should be taught the correct techniques and encouraged to make these exercises a lifetime habit. There is a weight on the ankle. Use of transcutaneous nerve stimulation (TENS) as an adjunct to other therapy for pain relief at the knee joint. The use of acupuncture, TENS and other local techniques to aid pain relief in difficult cases of OA is often worthwhile. Use of a cane, stick or other walking aid. This patient, who has hip OA, has found that she can reduce the pain in her damaged left hip by leaning on the stick in the right hand as she walks. The reduction in loading can be huge, and the effect on symptoms and confidence with walking very beneficial. The use of shoes and insoles to reduce impact loading on lower limb joints. They may help relieve pain as well as reducing the peak impact load on the joints during walking. Medications lessen the pain Over-the-counter Prescription-strength Surgery