arthritis knee brace

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Submitted by: leandro
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Arthritis Knee is caused due to various environmental triggers in genetically predisposed individuals.
The environmental triggers may be Infections, Hormonal influence, (Harris, 1993) Neuro-endocrine disturbance and Smoking. (Silman, 1996).
Bacterial Infections due to Streptococcal, Atypical mycobacteria, and Proteus, while viral infections due to Ebstein Barr virus, Rubella, Parvovirus, and Retrovirus have been attributed.
For reasons not fully understood the immune system of the body attacks the tissue surrounding the joints leading to infiltration of T-Lymphocytes and Plasma cells.
This is followed by proliferation of the synovial lining and formation of new blood vessels and seaweed like fronds and folds. This proliferation leads to the formation of ‘Pannus’ by covering of the cartilage and juxta-articular bony surface. The proliferation is first seen at the joint margins.
Due to this attack the joint lining or ‘synovium' becomes inflamed and enlarged and produces large quantities of synovial fluid.
This leads to swollen, sore and stiff joints.
If left untreated, this process damages the joint cartilage and erodes the bones, leading to joint destruction and deformity.

HOW IS IT DIAGNOSED?
The diagnosis of knee arthritis is essentially based on the clinical findings. As per the recommendations of the American Rheumatism Association (Arnett et al, 1988), the following diagnostic criteria are made.
1. Presence of morning stiffness of at least one hour for more than six weeks.
2. Arthritis of at least 3 joints with soft tissue swellings for mare than 6 weeks.
3. Arthritis of hands, at least one swollen area in wrist or Meta-Carpo-Phalangeal or Proximal Inter-Phalagial Joint for more than 6 weeks.
4. Symmetric arthritis of more than 6 weeks.
5. Presence of Rheumatoid nodules as diagnosed by a physician.
6. Presence of raised titre of Rheumatoid factor
7. Presence of Radiological changes
The presence of at least four of the above is considered diagnostic of Rheumatoid Arthritis but the points to be noted are:
Rheumatoid factor alone is no indicator of the presence or absence of the disease. A raised titre indicates a poor prognosis while more than 40% patients remain sero-negative throughout their life.
Diagnosis made on X-rays is already too late since joint damage has already set in.
Early diagnosis and aggressive management is the rule today, in order to prevent residual damage that takes about three months to occur. Further it takes most of the disease modifying drugs about six weeks to start working, so waiting six weeks for initiation of therapy may not be justified.
X-rays, laboratory tests, etc. are done to monitor the progress of the disease and effects of treatment.

WHAT ARE THE FOODS RESTRICTIONS?
There is no clear evidence for any food restrictions.
Food like rice, wheat, lentils, fruits, curd, buttermilk, red meat, have been linked to the disease but there is no clear evidence for this.
Weight loss in obese patients is advised.
Acidity, Flatulence & upset stomach are not related to the disease.

WHAT ARE THE EFFECTS OF WEATHER?
There are no long-term effects of weather.
Many people feel worse in cold and humid weather, and comfortable in dry and crisp conditions.
Winters or cold cause pain & stiffness of affected joints, but does not increase the Arthritis Knee