arthritis types with descriptions of unani system of medicine

1. IN THE NAME OF ALLAH, MOST GRACIOUS MOST MERCIFUL

3.  Arthritis (from Greek arthro, joint + -
itis, inflammation; plural: arthritides) is a form of jo
int
disorder that involves inflammation of one or more j
oints.


4. THERE ARE MORE THAN HUNDRED(>100)
TYPES OF ARTHRITIS
CAN BE CLASSIFIED IN TO TWO BASIC GROUPS
 Inflammatory
 Non inflammatory

5. INFLAMMATORY NON INFLAMMATORY
RHEUMATOID ARTHRITIS
PSORIATIC ARTHRITIS
ANKYLOSING SPONDILYITIS
BEHCET’S DISEASE
LUPUS
POLYMYALGIA RHEUMATICA
OSTEO ARTHRITIS
LUMBAGO (BACKACHE)
GOUT
SCLERODERMA

7.  osteo-, meaning "of the bone",
arthritis: arthr-, meaning "joint",
 itis, the meaning of which has come to be
associated with inflammation SO
 osteoarthosis is better term

8.  degenerative arthritis, degenerative joint
disease, osteoarthrosis
 It is the commonest form of arthritis
 usually occurring after middle age
 marked by chronic breakdown of cartilage in
the joints leading to pain,
stiffness, and swelling.

10.  Commonest form of arthritis
 25 crore people affected globally(3.5%)
 With severe disability to 4.5 crore people
 By age of 65 80% people have radiographic
changes in joints
 Half of NSAIDS prescriptions

11.  Osteoarthritis occurs when the cartilage that
cushions the ends of bones in joints
gradually deteriorates. Cartilage is a firm,
slippery tissue that permits nearly
frictionless joint motion. In osteoarthritis,
the slick surface of the cartilage becomes
rough. Eventually, if the cartilage wears
down completely, it may be left with bone
rubbing on bone.

13.  Old age
 Sex
 Obesity
 Joint injuries
 Occupational
 Genetics
 Bone deformities
 Other diseases

14.  Gross cartilage loss and morphological
damage to other joint tissues
 Swelling of joints
 Mild Inflammation of the synovium (joint
cavity lining) and the surrounding joint
capsule
 Meniscal tear
 Osteophyte formation

16.  OA commonly affects the hands, feet, spine, and the
large weight bearing joints, such as the hips and
knees
 Pain & tenderness
 Loss of ability
 Stiffness
 Bone spurs
 Crepitus
 Heberden's nodes (on the distal interphalangeal
joints)
 Bouchard's nodes (on the proximal interphalangeal
joints),
 Bunions
 Joint effusion

22.  .

24.  Thorough history taking
 Careful clinical examination
 Hematological tests
 Imaging

25.  Blood tests. Blood tests may help rule out
other causes of joint pain, such as
rheumatoid arthritis.
 Joint fluid analysis. Examining and testing
the fluid from the joint can determine if
there's inflammation and if pain is caused by
gout or an infection.

26.  X-Ray;
 1. joint space narrowing
2. subchondral sclerosis
3. subchondral cyst
4. osteophytes

27.  Periarticular structure derrangement
 Polymyalgia rheumatica
 Rheumatoid arthritis
 Lupus
 Sepsis

28.  Lifestyle modification (such as weight loss
and exercise) and analgesics are the
mainstay of treatment
 Exercising and achieving a healthy weight
are the best and most important ways to
treat osteoarthritis
 Physical therapy. A physical therapist can
work with you to create an individualized
exercise program that will strengthen the
muscles around your joint, increase your
range of motion and reduce pain.

29.  Occupational therapy. An occupational therapist
can help you by making your tasks easydiscover
ways to do everyday tasks or do your job without
putting extra stress on your already painful joint.
 Braces or shoe inserts. shoe inserts or other
devices are recommended that can help reduce
pain when patient stand or walk.

30.  Use heat and cold to manage pain. Both heat and
cold can relieve pain in your joint. Heat also
relieves stiffness, and cold can relieve muscle
spasms and pain.
 Use assistive devices to shift weight and pressure
from the joint
 Ilaj bil tadbir
 Yoga
 Joint replacement surgery

31.  It is a most common form of inflammatory joint
disease
 It is a symmetrical , destructive and deforming
polyarthitis affecting small & large synovial joints
 Associated extra articular features
 Presence of anti bodies(RF)

32.  Rheumatoid arthritis is derived from the
Greek word
 rheumatos - ("flow, current").
 oid ("resembling")
 gives the translation asjoint inflammation
that resembles rheumatic fever. Rheuma
which means watery discharge might refer to
the fact that the joints or swollen or that the
disease may be made worse by wet weather

33.  RA affects between 0.5 and 1% of adults
 In 2010 it resulted in about 49,000 deaths
globally.
 Onset is uncommon under the age of 15
 incidence rises with age until the age of 80.
 Women are affected three to five times as
often as men.
 The age at which the disease most commonly
starts is in women between 40 and 50 years
of age and later in men(but no age gp is
spared)

34.  Unknown cause
 Genetic
 Smoking
 Virus (Epstein-Barr virus (EBV) and Human
Herpes Virus 6 (HHV-6)
 Deficiency of Vit-D
 Mycoplasma

35.  Environmental factors ;
 For example, smoking tobacco
 Exposure to silica mineral
 Chronic periodontal disease
 Gut bacteria (microbes that inhabit the lining
of the bowels) that might trigger the onset of
rheumatoid arthritis in genetically
susceptible individuals. No specific microbes
have been identified as definite causes.

37.  joints become swollen
 tender and warm
 Stiffness (MORNING) limits their movement
 With time, multiple joints are affected
 Most commonly involved are the small joints
of the hands, feet and cervical spine
 Synovitis can lead to tethering of tissue with
loss of movement and erosion of the joint
surface causing deformity and loss of
function

38.  The rheumatoid nodule, which is sometimes
in the skin, is the most common non joint
feature.
 Fibrosis of the lungs is a recognized response
to rheumatoid disease
 Nephropathy
 MI
 Episcleritis
 Peripheral neuropathy

40.  Boutonniere deformity

46.  Carpal tunnel syndrome (CTS) is a medical
condition in which the median nerve is compressed
as it travels through the wrist at the carpal
tunnel and causes pain, numbness and tingling, in
the part of the hand that receives sensation from
the median nerve.

52.  Rheumatoid arthritis can be difficult to
diagnose in its early stages because the early
signs and symptoms mimic those of many
other diseases.
 There is no one blood test or physical finding
to confirm the diagnosis.

53.  Blood test
People with rheumatoid arthritis tend to have an
elevated erythrocyte sedimentation rate (ESR, or
sed rate), which indicates the presence of an
inflammatory process in the body. Other common
blood tests look for rheumatoid factor and anti-
cyclic citrullinate d peptide (anti-CCP) antibodies.
Rheumatoid Factor(RF)

54. Diagnosis will be done after 4 or more of
following features +ve
 Morning stiffness(>1 hour)
 Arthritis of 3 or more joints
 Arthritis of hand joints
 Symmetrical arthritis
 Rheumatoid nodules
 RF
 Radiological changes

55.  Viral Polyarthritis
 Systemic lupus erythematosus (SLE)
 Sjögren's syndrome
 Dermatomyositis (DM)
 Fibromyalgia
 Psoriatic arthritis
 Poly Myalgia Rheumatica

56.  "Turmeric (dar hald) is considered to be a cooling spice,
so it may be beneficial for the heat generated by
inflammation curcumin, the active ingredient that gives
turmeric its yellow color, may have antibacterial and
anticancer properties, as well as anti-inflammatory
properties that could help with rheumatoid arthritis.
 Green tea poly phenols anti oxidants suppress immune
system
 Cinnamon(Dalchini)
 Garlic(Lehsun )show anti inflammatory properties as
inhibit production of cytokines

57.  Peppers (filfil syah)have capsaicin, the substance
that gives hot peppers their heat, is used in gels and
creams as an arthritis treatment. Research published
in 2010 in the journal Natural Product
Communications found that many of the anti-
inflammatory properties found in capsaicin are also
found in black pepper.
 Ginger (zanjbeel) having gingerol check
inflammation

58.  Pain killers
 DMARD
 Steroids
 Exercise
 Heat & cold
 Relax

60.  Psoriatic arthritis is a form of arthritis that
affects some people who have psoriasis. It is
characterized by Joint pain, stiffness.
Arthritis is relatively mild to severe
 No cure for psoriatic arthritis exists, so the
focus is on controlling symptoms and
preventing damage to the joints. Without
treatment, psoriatic arthritis may be
disabling.

61.  Males & females are equally affected
 Majority of people affected during 30-55 age

62.  Unknown
 Auto immunity
 Genetic factors
 Environmental factors
 Physical trauma
 Bacterial or viral infection

63.  Psoriasis
 Family history
 Age (30-55)

64.  Swollen and painful fingers and toes
 Foot pain
 Lower back pain

65.  Reactive arthritis
 Rheumatoid arthritis
 Lupus erythmetosus
 Secondary syphilis
 Ankylosing spondilytis

66.  NSAIDs
 Disease-modifying antirheumatic drugs
(DMARDs)
 Immunosuppressants
 TNF-alpha inhibitors

67.  Surgical and other procedures
 Steroid injections.
 Joint replacement surgery

68. Lifestyle and home remedies
Protect your joints.
Maintain a healthy weight
Exercise regularly
Use cold and hot packs
Pace yourself.

69.  Gout is characterized by sudden, severe
attacks of pain, redness and tenderness in
joints, often the joint at the base of the big
toe often termed as podagra
 It may also present as tophi, kidney stones,
or urate nephropathy

70.  The word "gout" is derived from
the Latin word gutta, meaning "a drop" (of liquid).
 According to the Oxford English Dictionary, this is
derived from humorism and "the notion of the
'dropping' of a morbid material from the blood in
and around the joints"
ETYMOLOGY

71.  Crystalisation of uric acid due to
 Genetic predisposition
 Diet
 Under excretion of uric acid by kidneys
 Over production of uric acid
 Medical conditions
 Medication

74.  Severe unbearable pain (70% great toe)
 Insidous or sudden at night usually
 Hot, red , swollen
 Shining of overlying skin
 Dilated veins
 Tenderness
 Fever
 Attack may lasts for days n weeks but usually
subsides after few hours spontanously

79.  Gout may be diagnosed and treated without
further investigations in someone with
hyperuricemia and the classic podagra.
 Synovial fluid analysis should be done FOR a
definitive diagnosis of gout is based upon the
identification of monosodium urate
crystals in synovial fluid or a tophus

80.  Blood test
 Hyperuricemia –uric acid level (7.0 mg/dl) in males
(6.0 mg/dl) in females.
 Other blood tests commonly performed are white blood
cell count, renal function, and ESR.
 X-rays, while useful for identifying chronic gout,
have little utility in acute attacks
 USG
 Dual energy CT scan

81.  Bursitis
 Calcium pyrophosphate dihydrate crystal deposition disease
(CPPD, pseudogout)
 Dislocated joints
 Fractured joint
 Nephrolithiasis
 Psoriatic arthritis
 Rheumatoid arthritis
 Septic arthritis
 Synovitis
 Tendinitis
 Traumatic arthritis

82.  Aim is to lower down the uric acid level
 Life style changes & medication
 Reduce the meat and sea food
 Avoid alcohol
 Avoid obesity
 Reduce consumption of fruit drinks
 Eat citrus fruit for Vit C
Management Protocol

84.  Apple cider vinegar
 Lemon juice
 Cherries
 Baking soda
 Olive oil
 water
Management Protocol