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Osteoarthritis

Osteoarthritis (OA) is one of the most common forms of arthritis. It is a chronic


condition in which the material that cushions the joints, called cartilage, breaks down.
This causes the bones to rub against each other, causing stiffness, pain and loss of joint
movement. The cause is not fully understood.

People
About 27 million people in America have osteoarthritis. Common risk factors include
increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles,
and genetics.

Symptoms
Osteoarthritis symptoms usually develop gradually. At first, there may be soreness or
stiffness that seems more like a nuisance than a medical concern.
Common symptoms include:

Sore or stiff joints particularly the hips, knees, and lower back after inactivity
or overuse.
Stiffness after resting that goes away after movement.
Pain that is worse after activity or toward the end of the day.
Osteoarthritis, or OA, may also affect the neck, small finger joints, the base of the
thumb, ankle, and big toe. The pain may be moderate and come and go, without
affecting the ability to perform daily tasks. Some peoples OA will never progress past
this early stage. Others will have their OA get worse. The pain and stiffness of more
severe osteoarthritis may make it difficult to walk, climb stairs, sleep, or perform other
daily tasks.

Diagnosis
If you have symptoms of osteoarthritis, the doctor will ask questions about your medical
history and perform a physical exam and, possibly, take X-rays to confirm the
diagnosis.

Treatment
There is no cure for osteoarthritis, but there are medications to help relieve pain, when
needed. The doctor may recommend physical therapy (PT) or occupational therapy (OT)
to help improve strength and function. When pain is severe and frequent or mobility and
daily activities become difficult, surgery may be considered.

Self-care
Staying physically active and maintaining a healthy weight are the keys to living well
with osteoarthritis. Too little movement can lead to stiffness and weak joints. Losing one
pound can take four pounds of pressure off your knee joints. Overall fitness improves
health in many ways. Strong muscles protect joints. An OA management plan also
involves eating a nutritious diet, managing stress and depression, and getting a good
balance of rest and activity each day.

Managing Osteoarthritis Symptoms


Osteoarthritis, or OA, is a common disease affecting as some 27 million Americans,
causing pain, stiffness and swelling in joints. OA reduces your joints mobility,
interfering with your ability to work and live your life normally.
There is no cure for OA at this time. It will progress and damage your joints further
unless you intervene now. Luckily, there are many ways to manage OA symptoms.
Long-Term Management
As a person with osteoarthritis, youll need to take a long-term view of your health. OA
cant be bested in one day or with a single pill. Youll have to take a comprehensive
approach to your health.
You have a team to help you, including your arthritis doctor and other health care
professionals, your family and friends, and your local Arthritis Foundation office. But
you are the manager of that team. You must make a commitment to making healthy
changes and choices and sticking with the OA management plan that you and your
doctor will devise.
Top Tactics for Tackling OA
Your plan for taking on OA should include:

Managing OA symptoms, like pain, stiffness and swelling

Improving joint mobility and flexibility

Keeping your weight in check

Maintaining better fitness through physical activity

That sounds like a big project, but start by slowly making changes to your current
routine, not trying everything all at once. Here are tips for managing your OA, and
resources to help you.
Stretch Yourself. Slow, gentle stretching of joints may improve flexibility, lessen
stiffness and reduce pain. Morning is a great time to stretch to get joints ready for the
days tasks. The Arthritis Foundation offers stretching routines, including yoga- and tai
chi-based moves, approved for people with OA on DVD or in live classes in your area.
First, speak to your doctor to gauge your level of fitness and any special considerations.
Get Moving. Physical activity is a proven way to manage OA symptoms. Before you
groan about hating exercise, just pledge to progress from dedicated couch-sitter to
regular mover. Simple activities like walking around the neighborhood or taking a fun,
easy land or water exercise class approved for people with OA can reduce pain and
extra weight, which only worsens OA.

Exercising With Osteoarthritis


While you may worry that exercising with osteoarthritis could harm your joints and
cause more pain, research shows that people can and should exercise when they have
osteoarthritis. Exercise is considered the most effective non-drug treatment for
reducing pain and improving movement in osteoarthritis.
Three kinds of exercise are important for people with osteoarthritis: exercises involving
range of motion, also called flexibility exercises; endurance or aerobic exercises; and
strengthening exercises. Each one plays a role in maintaining and improving your ability
to move and function.
Speak with your doctor or physical therapist about exercising with osteoarthritis and the
specific exercises that are best for you.
Range of motion/flexibility: Range of motion refers to the ability to move your joints
through the full motion they were designed to achieve. When you have osteoarthritis,
pain and stiffness make it very difficult to move certain joints more than just a little bit,
which can make even the simplest tasks challenging.
Range-of-motion exercises include gentle stretching and movements that take joints
through their full span. Doing these exercises regularly ideally every day can help
maintain and even improve the flexibility in your joints.
Aerobic/endurance: These exercises strengthen your heart and make your lungs
more efficient. This conditioning has the added benefit of reducing fatigue, so you have
more stamina throughout the day. Aerobic exercise also helps control your weight by
increasing the amount of calories your body uses. Furthermore, this type of exercise
can help you sleep better and improve your mood.

How much should you exercise? Current recommendations for


150 minutes of moderate-intensity aerobic exercise per week
OR
75 minutes of vigorous-intensity aerobic exercise per week
OR
an equivalent combination of moderate and vigorous exercise
Strengthening: Strengthening exercises help maintain and improve your muscle
strength. Strong muscles can support and protect joints that are affected by arthritis.

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of
osteoarthritis include:

Pain. Your joint may hurt during or after movement.

Tenderness. Your joint may feel tender when you apply light pressure to it.

Stiffness. Joint stiffness may be most noticeable when you wake up in the
morning or after a period of inactivity.

Loss of flexibility. You may not be able to move your joint through its full range
of motion.

Grating sensation. You may hear or feel a grating sensation when you use the
joint.

Bone spurs. These extra bits of bone, which feel like hard lumps, may form
around the affected joint.

Factors that may increase your risk of osteoarthritis include:

Older age. The risk of osteoarthritis increases with age.

Sex. Women are more likely to develop osteoarthritis, though it isn't clear why.

Obesity. Carrying extra body weight contributes to osteoarthritis in several ways.


It puts added stress on weight-bearing joints, such as your hips and knees. In

addition, fat tissue produces proteins that may cause harmful inflammation in and
around your joints.

Joint injuries. Injuries, such as those that occur when playing sports or from an
accident, may increase the risk of osteoarthritis.

Certain occupations. If your job includes tasks that place repetitive stress on a
particular joint, that joint may eventually develop osteoarthritis.

Genetics. Some people inherit a tendency to develop osteoarthritis.

Bone deformities. Some people are born with malformed joints or defective
cartilage, which can increase the risk of osteoarthritis.

Other diseases. Having diabetes or other rheumatic diseases such as gout and
rheumatoid arthritis can increase your risk of osteoarthritis.

Preparing for your appointment


By Mayo Clinic Staff

Although you may initially bring your concerns to your family doctor, he or she may refer
you to a doctor who specializes in joint disorders (rheumatologist) or orthopedic surgery.

What you can do


You may want to write a list that includes:

Detailed descriptions of your symptoms

Information about medical problems you've had

Information about the medical problems of your parents or siblings

All the prescription and over-the-counter medications and dietary supplements you take
and the dosages
Questions you want to ask the doctor

What to expect from your doctor


Your doctor may ask some of the following questions:

When did your joint pain begin?

Is the pain continuous, or does it come and go?

Do any particular activities make the pain better or worse?

Have you ever injured this joint?

During the physical exam, your doctor will closely examine your affected joint, checking
for tenderness, swelling or redness, and for range of motion in the joint. Your doctor may
also recommend imaging and lab tests.

Imaging tests
Pictures of the affected joint can be obtained during imaging tests. Examples include:

X-rays. Cartilage doesn't show up on X-ray images, but cartilage loss is revealed by a
narrowing of the space between the bones in your joint. An X-ray may also show bone spurs
around a joint. Some people may have X-ray evidence of osteoarthritis before they
experience any symptoms.

Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field
to produce detailed images of bone and soft tissues, including cartilage. MRI isn't commonly
needed to diagnose osteoarthritis but may help provide more information in complex cases.

Lab tests
Analyzing your blood or joint fluid can help pinpoint the diagnosis.

Blood tests. Blood tests may help rule out other causes of joint pain, such as
rheumatoid arthritis.

Joint fluid analysis. Your doctor may use a needle to draw fluid out of the affected joint.
Examining and testing the fluid from your joint can determine if there's inflammation and if
your pain is caused by gout or an infection.

There's no known cure for osteoarthritis, but treatments can help reduce pain and
maintain joint movement.

Medications
Osteoarthritis symptoms may be helped by certain medications, including:

Acetaminophen.Acetaminophen (Tylenol, others) can relieve pain, but it doesn't reduce


inflammation. It has been shown to be effective for people with osteoarthritis who have mild
to moderate pain. Taking more than the recommended dosage of acetaminophen can cause
liver damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may reduce inflammation


and relieve pain. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and
naproxen (Aleve, others). Stronger NSAIDs are available by prescription. NSAIDs can cause
stomach upset, ringing in your ears, cardiovascular problems, bleeding problems, and liver
and kidney damage. They should not be used by people over 65 years of age and those who
have stomach bleeding. Topical NSAIDS have fewer side effects and may relieve pain just as
well.

Therapy
Exercising and achieving a healthy weight are the best and most important ways to treat
osteoarthritis. Your doctor also may suggest:

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.

Occupational therapy. An occupational therapist can help you discover ways to do


everyday tasks or do your job without putting extra stress on your already painful joint. For
instance, a toothbrush with a large grip could make brushing your teeth easier if you have
finger osteoarthritis. A bench in your shower could help relieve the pain of standing if you
have knee osteoarthritis.

Braces or shoe inserts. Your doctor may recommend shoe inserts or other devices that
can help reduce pain when you stand or walk. These devices can immobilize or support your
joint to help take pressure off it.

A chronic pain class. The Arthritis Foundation and some medical centers have classes
for people with osteoarthritis and chronic pain. Ask your doctor about classes in your area or
check with the Arthritis Foundation. These classes teach skills that help you manage your
osteoarthritis pain. And you'll meet other people with osteoarthritis and learn their tips and
tricks for reducing and coping with joint pain.

Surgical and other procedures


If conservative treatments don't help, you may want to consider procedures such as:

Cortisone shots. Injections of corticosteroid medications may relieve pain in your joint.
During this procedure your doctor numbs the area around your joint, then places a needle
into the space within your joint and injects medication. The number of cortisone shots you
can receive each year is limited, because the medication can worsen joint damage over
time.

Lubrication injections. Injections of hyaluronic acid may offer pain relief by providing
some cushioning in your knee. Hyaluronic acid is similar to a component normally found in
your joint fluid.

Realigning bones. During a surgical procedure called an osteotomy, the surgeon cuts
across the bone either above or below the knee to realign the leg. Osteotomy can reduce
knee pain by shifting your body weight away from the worn-out part of your knee.

Joint replacement. In joint replacement surgery (arthroplasty), your surgeon removes


your damaged joint surfaces and replaces them with plastic and metal parts. The hip and
knee joints are those most commonly replaced. Surgical risks include infections and blood
clots. Artificial joints can wear out or come loose and may need to eventually be replaced.
Repeat joint replacements are more challenging and less successful than the original
surgery.

Lifestyle changes and home treatments also can help reduce osteoarthritis symptoms.
You might want to try some of the following tips:

Exercise. Exercise can increase your endurance and strengthen the muscles
around your joint, making your joint more stable. Try walking, biking or swimming. If
you feel new joint pain, stop. New pain that lasts for hours after you exercise
probably means you've overdone it but doesn't mean you should stop exercising
altogether.

Lose weight. Being overweight or obese increases the stress on your weightbearing joints, such as your knees and your hips. Even a small amount of weight
loss can relieve some pressure and reduce your pain. Talk to your doctor about
healthy ways to lose weight. Most people combine changes in their diet with
increased exercise.

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.

Apply over-the-counter pain creams. Creams and gels available at drugstores


may provide temporary relief from osteoarthritis pain. Some creams numb the pain
by creating a hot or cool sensation. Other creams contain medications, such as
aspirin-like compounds, that are absorbed into your skin. Pain creams work best on
joints that are close to the surface of your skin, such as your knees and fingers.

Use assistive devices. Assistive devices can make it easier to go about your
day without stressing your painful joint. A cane may take weight off your knee or hip
as you walk. Carry the cane in the hand opposite the leg that hurts. Gripping and
grabbing tools may make it easier to work in the kitchen if you have osteoarthritis in
your fingers. Your doctor or occupational therapist may have ideas about what sorts
of assistive devices may be helpful to you. Catalogs and medical supply stores also
may be places to look for ideas.

People who aren't helped by medications for osteoarthritis pain sometimes turn to
complementary and alternative medicine practices for relief. Common treatments that
have shown some promise for osteoarthritis include:

Acupuncture. Some studies indicate that acupuncture can relieve pain and
improve function in people who have knee osteoarthritis. During acupuncture, hairthin needles are inserted into your skin at precise spots on your body. Risks include
infection, bruising and some pain where needles are inserted into your skin.

Glucosamine and chondroitin. Studies have been mixed on these nutritional


supplements. A few have found benefits for people with osteoarthritis, while most
indicate that these supplements work no better than placebo. Don't use glucosamine
if you're allergic to shellfish. Glucosamine and chondroitin may interact with blood
thinners such as warfarin and cause bleeding problems.

Avocado-soybean unsaponifiables. This nutritional supplement a mixture of


avocado and soybean oils is widely used in Europe to treat knee and hip
osteoarthritis. It acts as an anti-inflammatory, and some studies have shown it may
slow down or even prevent joint damage.

Tai chi and yoga. These movement therapies involve gentle exercises and
stretches combined with deep breathing. Many people use these therapies to reduce
stress in their lives, though small studies have found that tai chi and yoga may
reduce osteoarthritis pain. When led by a knowledgeable instructor, these therapies
are safe. Avoid moves that cause pain in your joints.

There's no known cure for osteoarthritis, but treatments can help reduce pain and
maintain joint movement.

Medications
Osteoarthritis symptoms may be helped by certain medications, including:

Acetaminophen.Acetaminophen (Tylenol, others) can relieve pain, but it doesn't reduce


inflammation. It has been shown to be effective for people with osteoarthritis who have mild
to moderate pain. Taking more than the recommended dosage of acetaminophen can cause
liver damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may reduce inflammation


and relieve pain. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and
naproxen (Aleve, others). Stronger NSAIDs are available by prescription. NSAIDs can cause
stomach upset, ringing in your ears, cardiovascular problems, bleeding problems, and liver
and kidney damage. They should not be used by people over 65 years of age and those who
have stomach bleeding. Topical NSAIDS have fewer side effects and may relieve pain just as
well.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease in which your bodys immune


system which protects your health by attacking foreign substances like bacteria and
viruses mistakenly attacks your joints. The abnormal immune response causes
inflammation that can damage joints and organs, such as the heart. Early diagnosis
and prompt treatment is the key to preventing joint destruction and organ damage.

People
About 1.5 million people in the United States have rheumatoid arthritis (RA). Nearly
three times as many women have the disease as men. In women, RA most commonly
begins between ages 30 and 60. In men, it often occurs later in life.

Symptoms
The severity of the disease can vary from person to person. Symptoms can change from
day to day. Sudden increases in symptoms and illness are called flares. A flare can last
for days or months. Key rheumatoid arthritis symptoms are pain, fatigue and warm,
swollen, reddish joints. Long periods of joint stiffness in the morning are common.
Inflammation in the small joints of the wrist and hand is typical. If a joint on one side of
the body is affected, the same one on the other side is usually affected, too.

Treatment
There is no cure for RA, but there are a number of medications available to help ease
symptoms, reduce inflammation, and slow the progression of the disease. No one drug
works for everyone but many people find treatments that are very effective. The goal of
treatment is remission, a state when inflammation is gone or is very low. A doctor, likely
a rheumatologist a specialty doctor who treats people with arthritis should monitor
your levels of disease activity, or inflammation, on a regular basis through exams and
blood tests that reveal how well treatment is working. The doctor may add or change
your medications or adjust the dosage after a few months, if the disease is still active.

Self-care
Self-management is an important part of rheumatoid arthritis care. Staying physically
active is the key to keeping joints flexible. Too little movement can lead to joint stiffness.
Strong muscles protect joints. Overall fitness improves health in many ways. Managing
your weight, eating a nutritious diet and getting a good balance of rest and activity each
day are important, too.

Rheumatoid Arthritis Medications


There are many rheumatoid arthritis medications available to lower joint pain, swelling,
and inflammation. Some of these drugs prevent or slow the progression of the disease.
Drugs that offer relief of arthritis symptoms (joint pain, stiffness, and swelling) include:

Anti-inflammatory painkillers, such as aspirin, ibuprofen, or naproxen

Topical (applied directly to the skin) pain relievers

Corticosteroids, such as prednisone

Narcotic pain relievers

There are also many strong medications called disease-modifying antirheumatic drugs
(DMARDs), which work by interfering with or suppressing the immune system's attack
on the joints. They include:

Plaquenil (originally used to treat malaria)

Immune suppression drugs, such as methotrexate, Imuran, and Cytoxan

Biologic treatments, such as Actemra, Cimzia, Kineret, Simponi, Enbrel, Humira,


Remicade, Orencia, and Rituxan

Other drugs, such as Azulfidine, Arava, and Xeljanz

Differential diagnoses[edit]
Several other medical conditions can resemble RA, and usually need to be distinguished from it at
the time of diagnosis:[55][56]

Crystal induced arthritis (gout, and pseudogout) usually involves particular joints (knee,
MTP1, heels) and can be distinguished with aspiration of joint fluid if in doubt. Redness,
asymmetric distribution of affected joints, pain occurs at night and the starting pain is less than
an hour with gout.

Osteoarthritis distinguished with X-rays of the affected joints and blood tests, age (mostly
older persons), starting pain less than an hour, a-symmetric distribution of affected joints and
pain worsens when using joint for longer periods.

Systemic lupus erythematosus (SLE) distinguished by specific clinical symptoms and blood
tests (antibodies against double-stranded DNA)

One of the several types of psoriatic arthritis resembles RA nail changes and skin
symptoms distinguish between them

Lyme disease causes erosive arthritis and may closely resemble RA it may be
distinguished by blood test in endemic areas

Reactive arthritis (previously Reiter's disease) asymmetrically involves


heel, sacroiliac joints, and large joints of the leg. It is usually associated
with urethritis, conjunctivitis,iritis, painless buccal ulcers, and keratoderma blennorrhagica.

Ankylosing spondylitis this involves the spine, although a RA-like symmetrical small-joint
polyarthritis may occur in the context of this condition.

Hepatitis C RA-like symmetrical small-joint polyarthritis may occur in the context of this
condition. Hepatitis C may also induce Rheumatoid Factor auto-antibodies

Rarer causes that usually behave differently but may cause joint pains: [55]

Sarcoidosis, amyloidosis, and Whipple's disease can also resemble RA.

Hemochromatosis may cause hand joint arthritis.

Acute rheumatic fever can be differentiated from RA by a migratory pattern of joint


involvement and evidence of antecedent streptococcal infection. Bacterial arthritis (such as
streptococcus) is usually asymmetric, while RA usually involves both sides of the body
symmetrically.

Gonococcal arthritis (another bacterial arthritis) is also initially migratory and can
involve tendons around the wrists and ankles.

Tendinitis
What is it?
Arthritis is a complex family of musculoskeletal disorders consisting of more than 100
different diseases or conditions that destroy joints, bones, muscles, cartilage and other
connective tissues, hampering or halting physical movement. A tendon is a cord of
tough tissue that connects muscle to bone. The tendon is surrounded by a sheath that
protects and lubricates the tendon. This sheath is lined by a layer of cells called the

synovium. Occasionally, the tendon will become inflamed (called tendinitis) or the
tendon sheath will become inflamed (called tenosynovitis). These conditions together
are known as tendinitis and result in pain, stiffness and sometimes swelling.
Tendinitis usually is caused by a specific injury or by repetitive overuse, especially when
using poor body position. Tendinitis can occur in young athletic people in response to
sports injuries and overuse. However, tendons become less flexible with aging and
tendinitis is common in middle aged and older adults.
In general, tendinitis can occur suddenly, may last for days, weeks or longer, and then
go away. It can, however, occur again in the same place. When properly treated, it
general doesnt result in permanent damage or disability.

What are the effects?


Tendons all over the body can become inflamed, including shoulders, elbows, wrists,
fingers, hips, back, knees, ankles and feet. The symptoms usually include pain, stiffness
and swelling.

How is it diagnosed?
Diagnosing tendinitis is based primarily on a physical exam and a medical history. Your
doctor will look for swelling and tenderness in the area that is bothering you. He or she
will rule out infection if there is no heat and redness associated with the swelling and
tenderness. He or she will ask you about the pain and about what types of activities you
are involved in. That is usually enough for the doctor to diagnose tendinitis. If the
diagnosis is in question or if the doctor suspects that you may have an underlying
inflammatory disease, he or she may run some routine laboratory tests and X-rays.

What are the treatment options?


Tendinitis is common in people who are otherwise healthy. It may go away on its own
over time. In most cases, a primary-care physician can treat tendinitis. Some people
may need to be referred to a rheumatologist, an orthopaedic surgeon or a physical
therapist for treatment.

Tendinitis is treated with a conservative approach. Your doctor may recommend a


combination of rest, activity modification, heat and cold, medications, and physical
therapy.
Rest: The affected tendon should be rested so it can heal. You may have to stop
performing the offending activity for a short period of time.
Activity modification: The activity that caused the injury should be modified in
such a way as to relieve the stress on the tendon. For example, if running gave you
Achilles tendinitis, you may need to reduce your mileage, wear different shoes and then
increase your mileage slowly.

o
o

Splints: Sometimes splints are used to keep the affected joint in alignment
during activities so stress is taken off the tendon (such splints and wraps are available
for tennis elbow). Splints may also be used during the initial resting period to allow the
tendon to heal.
Cold and heat: Cold packs, slush baths, and ice rubs can reduce pain and
swelling when the tendon is newly injured or is really bothering you. Hot packs, heating
pads, or warm baths can feel good for the long-term ache that you may feel from an
overuse injury.
Medication:
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken to relieve the
pain and swelling of tendinitis. Other analgesics can be added for pain relief.
Steroids can be injected into the tendon sheath for very direct pain and
inflammation relief. Certain tendons should not be injected with steroids because it puts
the tendon as risk of rupture (the Achilles for example).
Physical therapy: A physical therapist can teach techniques to stretch the
affected tendon, thereby reducing the likelihood of reinjury. He or she can also assess
your body mechanics and teach you better ways to perform the activities that give you
trouble. Shoe inserts (orthotics) may be needed to adjust your running form, relieving
pressure on your knee and Achilles tendons.
Surgery: Rarely surgery may be needed to relieve the symptoms of tendinitis.
Surgery would also be necessary if the affected tendon tore or ruptured.

osteoartritis
Overview
Bentuk paling umum dari artritis yaitu Osteoarthritis (OA) mempengaruhi sekitar 40% dari populasi
orang dewasa. Dari semua orang ini, hanya 10% yang mencari pengobatan medis dan hanya 1% yang
benar-benar lumpuh.

Penyebab
Osteoartritis (OA) berarti radang sendi, walaupun lebih dikenali sebagai penyakit degeneratif yang
karena disebabkan oleh peradangan sendi dengan penipisan tulang rawan yang berkaitan. Tulang
rawan pada persendian kita memungkinkan pergerakan sendi yang mulus. Ketika tulang rawan ini
rusak karena cedera, infeksi, atau efek penuaan, pergerakan sendi menjadi terganggu. Akibatnya,
jaringan di dalam sendi mengalami iritasi serta menyebabkan rasa nyeri dan pembengkakan.

Gejala
Dalam OA, Anda tidak akan mengalami masalah saat bangun di pagi hari, namun masalah timbul saat
hari beranjak siang.
Di petang hari, pasien dapat merasakan rasa sakit dalam intensitas sedang di daerah persendian yang
bermasalah.

Gejala umum lainnya termasuk:

Nyeri

Bengkak sendi

Pembengkakan pada sendi yang bermasalah

Perubahan di daerah sekitar sendi

Rasa hangat Sendi yang mengalami artritis terasa hangat jika disentuh

Crepitation Perasaan seperti diparut atau diasah pada sendi yang bermasalah karena saling
bergesekannya permukaan tulang rawan

Kista Pada OA yang terjadi pada tangan, kista berukuran kecil dapat tumbuh, ini
menyebabkan timbulnya benjolan atau lekukan pada bagian luar kuku jari yang sakit

Perubahan yang disebabkan oleh artritis degeneratif cenderung terjadi pada persendian yang sejenis.
Sedangkan dalam artritis degeneratif pasca-trauma yang memiliki riwayat trauma akut atau kronis,
perubahan ini cenderung terjadi hanya pada persendian yang sakit.

Faktor Resiko
Usia Lanjut
Seiring bertambahnya usia, kemungkinan berkurangnya fungsi tulang rawan juga semakin bertambah.
OA jarang dijumpai pada orang yang berusia di bawah 40 tahun.
Jenis Kelamin
Wanita lebih tinggi kemungkinannya untuk menderita OA, terutama setelah menopause.
Cedera Sendi Sebelumnya
Seseorang yang sebelumnya pernah menderita cedera tulang rawan pada sendi, misalnya setelah
patah tulang di daerah sendi atau cedera olahraga pada sendi berisiko lebih tinggi terkena OA di
kemudian hari.
Berat Badan
Berat badan diatas berat ideal memberikan tekanan ekstra pada persendian yang berfungsi menahan
beban seperti panggul dan lutut, sehingga persendian di kedua tempat ini besar kemungkinannya
akan memunculkan OA.
Deformitas atau Kelainan Bentuk Tulang
Orang yang menderita kelainan bentuk persendian atau tulang rawan sejak lahir lebih berisiko
menderita OA.
Penyakit Lainnya Yang Mempengaruhi Persendian
Penyakit tulang dan sendi yang meningkatkan risiko terjadinya OA juga mencakup kondisi artritis
lainnya seperti artritis rematoid dan gout (asam urat).

Genetik
Faktor genetik mempengaruhi perkembangan OA.

Diagnosa
Spesialis akan mulai mencatat riwayat masalah Anda dan masalah kesehatan sebelumnya, dilanjutkan
dengan pemeriksaan fisik. Ini dapat dilanjutkan dengan tes lain, seperti:
Sinar-X (Rontgen)
Ini adalah tes paling umum yang dilakukan untuk mengevaluasi status sendi dan kesejajaran sendi
yang bermasalah. Sinar-X aman, mudah dan tidak sakit.
Tes Darah
Tergantung dari hasil pemeriksaan klinis, darah dapat diambil untuk pemeriksaan khusus untuk
mengesampingkan penyebab nyeri sendi yang lain seperti artritis rematoid, gout (asam urat), atau
infeksi.
Pengambilan Cairan Sendi
Kadang-kadang, terutama apabila sendi sangat membengkak, dokter mengambil sejumlah cairan dari
sendi yang bengkak untuk pemeriksaan khusus. Pembuangan cairan sendi kadang-kadang juga dapat
menghilangkan rasa sakit.

Pengobatan
Tujuan pengobatan osteoartritis :
i. Menghilangkan rasa sakit
ii. Mempertahankan fungsi
iii. Mencegah deformitas atau kelainan bentuk
iv. Mendidik pasien
Perawatan OA tergantung pada tingkat keparahan penyakitnya dan harapan gaya hidup pasien

sendiri.
OA tahap dini pada umumnya dapat diobati dengan:

Istirahat dan perubahan gaya hidup, seperti menurunkan berat badan dan berhenti merokok

Penggunaan alat bantu (misalnya tongkat jalan). Memakai sepatu yang sesuai juga membantu
untuk mengurangi gejala pada beberapa kasus OA

Latihan dan fisioterapi untuk memperkuat otot dan meningkatkan fleksibilitas sendi

Pengobatan

Untuk OA pada tangan, tangan dapat diistirahatkan dengan membebat sendi dengan splint/bidai agar
tidak bergerak. Penggunaan splint atau bidai ini pada awalnya dilakukan selama 3 4 minggu, di
mana splint dipakai secara terus menerus.
Ini biasanya dikombinasikan dengan obat-obatan anti-peradangan (nonsteroidal anti-inflammatory
drugs, NSAIDs) pada waktu yang sama. Jika gejalanya membaik, penggunaan splint di siang hari
dapat mulai dikurangi selama beberapa bulan mendatang.
Penggunaan NSAID
Efeknya pada saluran pencernaan tetap menjadi salah satu faktor utama yang membatasi
penggunaan NSAIDs dan mungkin mengharuskan penghentian penggunaan bahan anti-peradangan
ini secara permanen. Penggunaan penghambat H2, omeprazol, atau misoprostol, serta bahan serupa
prostaglandin yang meniadakan efek mukus atau lendir dari NSAIDs, dapat mengurangi sebagian efek
pada pencernaan perut. Neprotoksisitas adalah komplikasi yang umum terjadi sebagai akibat dari
penggunaan NSAIDs, dan pasien yang ginjalnya tidak berfungsi penuh tidak boleh menggunakan
NSAIDs dalam jangka waktu lama.
Jenis-jenis Pengobatan
Saat ini tidak ada satu pun obat yang dapat menyembuhkan OA atau menumbuhkan kembali tulang
rawan pada persendian osteoartritis.
Obat yang paling umum diberikan pada resep adalah obat penghilang rasa sakit. Jenis obat
penghilang rasa sakit yang diresepkan tergantung pada keparahan rasa sakitnya. Untuk penyakit
tingkat awal yang rasa nyerinya masih ringan dan terjadi sesekali, obat penghilang rasa sakit
sederhana seperti paracetamol (Panadol) bisa efektif, walaupun untuk rasa sakit yang lebih parah
mungkin membutuhkan penggunaan obat anti-peradangan (NSAIDs) untuk menguranginya. Krim
analgesik (penghilang rasa sakit) dan koyok dapat juga digunakan.
Glukosamin, dengan atau tanpa kondroitin, juga menjadi opsi pengobatan yang semakin populer
dalam beberapa tahun terakhir. Obat ini dapat dibeli tanpa resep dari dokter.
Walaupun demikian, obat ini tidak efektif pada kebanyakan pasien, terutama yang menderita OA
parah. Redanya gejala juga cenderung berlangsung sementara. Selain itu, tidak ada bukti bahwa
glukosamin atau kondroitin dapat memulihkan tulang rawan.
Suntik
Untuk perawatan OA, dokter Anda terkadang merekomendasikan suntikan steroid ke dalam atau di
seputar sendi jika perawatan konservatif yang disebut sebelumnya tidak memberikan hasil yang
diinginkan. Walaupun penggunaan penghilang rasa sakit dapat sangat memuaskan, biasanya efeknya
hanya untuk sementara, dan dokter Anda akan membatasi jumlah suntikan steroid yang boleh diterima

karena pemakaian berulang dapat melemahkan tendon sehingga memperburuk kondisi tulang rawan
yang sudah rusak.

Bedah
Pembedahan biasanya ditawarkan untuk penyakit dengan tingkat keparahan akut yang tidak bereaksi
terhadap perawatan yang telah disebut di atas. Jenis pembedahan maupun keputusan melakukan
pembedahan biasanya dilakukan setelah diskusi panjang dengan dokter Anda.
Untuk sebagian besar persendian pada tangan, artodesis atau fusi sendi sering menjadi metode yang
dipilih. Dalam fusi sendi, permukaan artritis dihilangkan, dan tulang pada kedua sisi sendi dipadukan
untuk menghilangkan gerakan pada sendi yang bermasalah.
Ini mungkin mengakibatkan gerakan tertentu tidak dapat dilakukan lagi, namun penghilangan rasa
nyeri dan stabilitas pada sendi bisa meningkatkan fungsi sendi yang terpengaruh oleh penyakit sendi
degeneratif.

Arthritis adalah istilah umum yang berarti peradangan pada sendi. Radang sendi ditandai
dengan kemerahan, rasa hangat, bengkak, dan nyeri di dalam sendi.
Rheumatoid arthritis adalah jenis peradangan sendi kronis yang biasanya terjadi pada sendi
di kedua sisi tubuh, seperti tangan, pergelangan tangan, atau lutut. Kesimetrian ini
membantu membedakan rheumatoid arthritis dari jenis arthritis yang lain.
Selain mempengaruhi sendi, rheumatoid arthritis sesekali dapat mempengaruhi kulit, mata,
paru-paru, jantung, darah, atau saraf.
Apakah Gejala Rheumatoid Arthritis?
Gejala-gejala dari rheumatoid arthritis meliputi:

Nyeri sendi dan bengkak

Kekakuan, terutama di pagi hari atau setelah duduk untuk waktu yang lama

Kelelahan
Rheumatoid arthritis ini berbeda-beda pengaruhnya pada masing-masing orang. Pada
beberapa orang, gejala sendi berkembang secara bertahap selama beberapa tahun.
Sedangkan pada beberapa yang lain,rheumatoid arthritis dapat berkembang dengan cepat.
serta ada juga yang mungkin memiliki rheumatoid arthritis untuk jangka waktu tertentu dan
kemudian memasuki masa remisi.
Siapa yang Dapat Terkena Rheumatoid Arthritis?
Rheumatoid arthritis adalah penyakit autoimun yang mempengaruhi sekitar 1% populasi di
Amerika Serikat. Penyakit ini dua sampai tiga kali lebih sering terjadi pada wanita
dibandingkan pria. Namun pada pria yang terkena penyakit ini, cenderung pengaruhnya
lebih parah. Rheumatoid arthritis biasanya terjadi pada usia pertengahan, namun anakanak dan orang tua juga dapat terkena rheumatoid arthritis.
Apa Penyebab Rheumatoid Arthritis?
Penyebab pasti dari rheumatoid arthritis, belum diketahui pasti, tetapi diduga penyakit ini
disebabkan oleh kombinasi dari faktor genetik, lingkungan, dan hormonal. Pada rheumatoid
arthritis, ada suatu hal yang memicu sistem kekebalan tubuh untuk menyerang sendi dan
kadang-kadang organ lainnya. Beberapa teori menyarankan bahwa ada virus atau bakteri
yang mungkin mengubah sistem kekebalan tubuh, sehingga menyebabkan sistem
kekebalan tersebut menyerang sendi. Teori lain menyarankan bahwa merokok dapat
menyebabkan terkena rheumatoid arthritis.
Penelitian belum sepenuhnya menentukan secara pasti apa peran genetika bermain
dalam rheumatoid arthritis. Namun, beberapa orang tampaknya memiliki faktor genetik atau
turunan yang meningkatkan kemungkinan mereka terkena rheumatoid arthritis.
Bagaimana Rheumatoid Arthritis Mempengaruhi Tubuh Kita?
Setelah sistem kekebalan tubuh dipicu, sel-sel kekebalan bermigrasi dari darah ke dalam
sendi dan sendi-lapisan jaringan, disebut sinovium. Di tempat tersebut, sel-sel kekebalan
tubuh menghasilkan zat inflamasi yang menyebabkan iritasi, mengikis tulang rawan (bahan
bantalan pada bagian akhir tulang), serta pembengkakan dan peradangan pada lapisan
sendi. Seiring tulang rawan terkikis, ruang antara tulang-tulang menyempit. Jika kondisi
tersebut memburuk, maka tulang bisa bergesekan satu dengan yang lain.

Radang lapisan sendi menimbulkan cairan berlebih terhadap sendi. Seiring lapisan
mengembang, maka hal ini mungkin mengikis tulang yang berdekatan, sehingga
mengakibatkan kerusakan pengikat antara tulang.
Semua hal diatas menyebabkan sendi menjadi sangat sakit, bengkak, dan terasa hangat
saat disentuh.
Bagaimana Rheumatoid Arthritis Didiagnosis?
Diagnosis rheumatoid arthritis didasarkan pada kombinasi bernacam faktor, termasuk
diantaranya:

Lokasi dan kesimetrian nyeri sendi yang spesifik, terutama sendi tangan

Adanya kekakuan sendi di pagi hari

Adanya benjolan dan nodul di bawah kulit (nodul rheumatoid)

Hasil tes x-ray yang menunjukkan adanya rheumatoid arthritis

Hasil faktor rheumatoid positif dari tes darah yang dilakukan serta tes darah lainnya
Kebanyakan
orang
yang
terkena rheumatoid
arthritis memiliki
antibodi
faktor rheumatoid (RF) dalam darah mereka. Namun terkadang ada orang yang tidak
memiliki antibodi ini dan terkena rheumatoid arthritis karena ada penyakit lain yang bisa
menyebabkan faktor rheumatoid untuk diproduksi dalam darah. Oleh karena
itu, diagnosis rheumatoid arthritis didasarkan dari kombinasi kelainan sendi serta
hasil tes darah.
Tes darah yang baru dan lebih spesifik untuk rheumatoid arthritis adalah tes
antibodi citrulline cyclic, juga disebut anti-CCP. Kehadiran antibodi anti-CCP ini
menunjukkan kecenderungan bentuk rheumatoid arthritis yang lebih agresif.
Orang-orang dengan rheumatoid arthritis mungkin mempunyai anemia ringan. Tes darah
juga dapat mengungkapkan tingkat sedimentasi eritrosit (ESR) atau peningkatan tingkat
protein C-reactive (CRP), yang merupakan penanda adanya peradangan.

Beberapa orang dengan rheumatoid arthritis juga mungkin memiliki hasil positif pada tes
antibodi antinuclear (ANA), yang menunjukkan adanya gangguan autoimun, apakah
gangguan tersebut rheumatoid arthritis atau penyakit autoimun yang lain.
Bagaimana Mengobati Rheumatoid Arthritis?
Ada bermacam cara untuk mengobati rheumatoid arthritis. Pengobatan termasuk obatobatan, istirahat dan olahraga, serta tindakan operasi untuk memperbaiki kerusakan pada
sendi.
Jenis pengobatan yang digunakan tentunya tergantung pada beberapa faktor, yang
termasuk diantaranya yaitu usia, kesehatan secara keseluruhan, riwayat kesehatan, dan
tingkat keparahan arthritis.
Obat-obatan untuk Rheumatoid Arthritis
Terdapat banyak obat-obatan rheumatoid arthritis yang tersedia untuk mengurangi nyeri
sendi, bengkak, dan peradangan. Beberapa obat tersebut untuk mencegah atau
meminimalkan perkembangan penyakit. Perlu diingat, obat-obat ini ada yang memerlukan
resep dokter. Jadi Anda perlu konsultasikan dahulu dengan dokter Anda sebelum
mengkonsumsinya demi efektivitas dan keamanan.
Obat-obatan yang membantu mengurangi gejala arthritis, seperti nyeri sendi, kekakuan,
dan pembengkakan, antara lain:

Obat anti-inflamasi penghilang rasa sakit, seperti aspirin, ibuprofen, atau naproxen

Penghilang rasa sakit topikal (dioleskan langsung ke kulit)

Kortikosteroid, seperti prednison

Obat penghilang rasa sakit golongan narkotika


Ada juga obat keras yang disebut disease-modifying anti-rheumatic drugs (DMARDs), yang
bekerja dengan menghalangi atau menekan serangan sistem kekebalan tubuh pada sendi.
Obat-obat tersebut antara lain:

Plaquenil (awalnya digunakan untuk mengobati malaria)

Obat penekanan kekebalan tubuh, seperti methotrexate, Imuran, dan Cytoxan

Pengobatan Biologis , seperti Enbrel, Humira, Remicade, Orencia, Rituxan, dan


Xeljanz

Obat-obat lain, seperti Azulfidine dan Arava


Mengapa Istirahat dan Latihan Olahraga Sangat Penting untuk Rheumatoid Arthritis?
Keseimbangan antara istirahat dan olahraga sangat penting dalam mengobati rheumatoid
arthritis. Sewaktuflare-up, yaitu memburuknya radang sendi, tindakan yang terbaik adalah
untuk mengistirahatkan sendi yang meradang. Hal ini dapat dicapai dengan penggunaan
sementara tongkat atau joint splints, yaitu perangkat yang digunakan agar sendi tidak dapat
digerakkan.
Ketika peradangan sendi berkurang, program panduan olahraga diperlukan untuk
mempertahankan fleksibilitas sendi dan memperkuat otot-otot yang mengelilingi sendi.
Rentang gerakan olahraga harus dilakukan secara teratur untuk menjaga mobilitas sendi.
Kapan Tindakan Bedah Diperlukan untuk Rheumatoid Arthritis?
Ketika kerusakan sendi dari rheumatoid arthritis telah parah atau nyeri yang tidak bisa
dikendalikan dengan obat-obatan, maka operasi mungkin menjadi pilihan untuk membantu
memulihkan fungsi sendi yang rusak.
Dapatkah Rheumatoid Arthritis Disembuhkan?
Walaupun tidak ada obat untuk menyembuhkan rheumatoid arthritis, namun pengobatan
dini dan agresif telah terbukti membantu mencegah kecacatan.
Sumber: WebMD

Cedera Ligamen
Ada 4 ligamen, yaitu tough band tissues, pada lutut yang menstabilisasikan sendi. Ligamen yang
paling sering cedera adalah anterior cruciate ligament (ACL).
Mencegah gerakan menyamping abnormal dari lutut adalah ligamen kolateral, ligamen kolateral
medial (MCL), dan ligamen kolateral lateral (LCL), yang terletak di dalam dan di luar setiap lutut.
Cedera pada ligamen kolateral, seperti ligamen kolateral medial (MCL), dan ligamen kolateral lateral
(LCL) biasanya disebabkan oleh tumbukan langsung pada pinggir lutut atau cedera karena terpuntir.

Ini dapat terjadi sendiri atau bersama dengan cedera ACL atau PCL.

Diagnosis

Diagnosis didasarkan pada riwayat dan pemeriksaan klinis. Gejalanya dapat berupa rasa sakit dan
pembengkakan pada lokasi cedera dan lutut terasa tidak stabil.

Pengobatan Cedera Ligamen


Pengobatan cedera ligamen diantaranya adalah istirahat, mengangkat dan kompres es pada kaki yang
sakit. Penggunaan kruk untuk mengurangi beban pada lutut dan penopang untuk menahan lutut juga
dapat diberikan.
Fisioterapi untuk memperkuat otot penyokong dan menambah kemampuan berbagai gerakan
biasanya juga dilakukan sebagai bagian dari pengobatan.
Tergantung pada situasinya, dokter Anda dapat menyarankan dilakukannya pembedahan untuk
memperbaiki atau membentuk kembali ligamen.