By Dr. med. Rainer Berger (auth.), H. Ralph Schumacher Jr. MD (eds.)
This quantity reports the cutting-edge in osteoarthritis. The pathogenetic roles of mechanical, systemic and inflammatory elements and the significance of neurogenic elements in soreness administration and within the reasons of disorder are thought of. Of specific worth is the overview of the consequences of pathogenetic mechanisms in destiny modes of administration. the idea that of "activated arthrosis" is given specific realization. ultimately, arguable matters and new parts for research are mentioned. The e-book may also help the clinician and the investigator think about the significance of addressing diverse levels and subtypes of osteoarthritis in making plans treatment.
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Extra info for Osteoarthritis: Diagnosis and Therapy: Proceedings of an International Meeting
MULLER-FASSBENDER Summary The significance of degenerative joint disorders in rheumatic disease is stressed in this paper. First, the differences between inflammatory and degenerative diseases are discussed and subsequently the similarity between former disease and the activated degenerative processes is demonstrated. The chapter deals first with those joints prone to degenerative joint processes. Further on, the possibility of therapy with chondroprotective substances is stressed with special reference to the problem of demonstrating the effectiveness of the actual treatment.
Kinds of pain typical of arthrosis are start-up pain, pain due to fatigue, and loading pain. Start-up pain obviously occurs in the hip, knee, and ankle joints. As a result of the joint changes, it can also occur while at rest. In addition, the pain in the surrounding structures, especially the musculature and the tendon attachments, may be potentiated. Swelling of the joints, as in inflammatory rheumatic diseases, occurs only in the activated state, becoming manifest here in the form of a hyperthermia.
In some patients pain is due to noninflammatory causes such as periosteal elevation associated with osteophyte formation or subchondral trabecular microfractures, as previously noted. In these patients analgesic agents such as acetaminophen and propoxyphene hydrochloride alone may be efficacious. Although acetaminophen is a generally safe drug, total daily doses should be limited so as to avoid hepatic toxicity; a dose of 2400 mg/day on a regular basis should generally not be exceeded. Lower doses or avoidance of the drug are essential if the patient has known liver disease.
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