What is Gout?

What Is Gout?

Gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:

Sharp uric acid crystal deposits in joints, often in the big toe

Deposits of uric acid (called tophi) that look like lumps under the skin

Kidney stones from uric acid crystals in the kidneys.

For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen.

Gout can cause:

Pain

Swelling

Redness

Heat

Stiffness in joints.

In addition to the big toe, gout can affect the:

Insteps

Ankles

Heels

Knees

Wrists

Fingers

Elbows.

A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years.

What Causes Gout?

Gout is caused by the buildup of too much uric acid in the body. Uric acid comes from the breakdown of substances called purines. Purines are found in all of your body's tissues. They are also in many foods, such as liver, dried beans and peas, and anchovies.

Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But uric acid can build up in the blood when:

The body increases the amount of uric acid it makes.

The kidneys do not get rid of enough uric acid.

A person eats too many foods high in purines.

When uric acid levels in the blood are high, it is called hyperuricemia. Most people with hyperuricemia do not develop gout. But if excess uric acid crystals form in the body, gout can develop.

You are more likely to have gout if you:

Have family members with the disease

Are a man

Are overweight

Drink too much alcohol

Eat too many foods rich in purines

Have an enzyme defect that makes it hard for the body to break down purines

Are exposed to lead in the environment

Have had an organ transplant

Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa

Take the vitamin niacin.

How Is Gout Diagnosed?

Your doctor will ask about your symptoms, medical history, and family history of gout. Signs and symptoms of gout include:

Hyperuricemia (high level of uric acid in the blood)

Uric acid crystals in joint fluid

More than one attack of acute arthritis

Arthritis that develops in 1 day, producing a swollen, red, and warm joint

Attack of arthritis in only one joint, usually the toe, ankle, or knee.

To confirm a diagnosis of gout, your doctor may draw a sample of fluid from an inflamed joint to look for crystals associated with gout.

How Is Gout Treated?

Doctors use medicines to treat an acute attack of gout, including:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Corticosteroids, such as prednisone

Colchicine, which works best when taken within the first 12 hours of an acute attack.

Sometimes doctors prescribe NSAIDs or colchicine in small daily doses to prevent future attacks. There are also medicines that lower the level of uric acid in the blood.

What Can People With Gout Do to Stay Healthy?

Some things that you can do to stay healthy are:

Take the medicines your doctor prescribes as directed.

Tell your doctor about all the medicines and vitamins you take.

Plan followup visits with your doctor.

Maintain a healthy, balanced diet. Avoid foods that are high in purines, and drink plenty of water.

Exercise regularly and maintain a healthy body weight. Ask your doctor about how to lose weight safely. Fast or extreme weight loss can increase uric acid levels in the blood.

What Research Is Being Done on Gout?

Scientists are studying:

Which NSAIDs are the most effective treatments for gout

Optimal dosages of medications for gout

New medicines that safely lower uric acid in the blood and reduce symptoms

New therapies that block a chemical called tumor necrosis factor

Enzymes that break down purines in the body

The role of foods and certain vitamins

The role of genetics and environmental factors

The interactions of cells involved in acute gout attacks.

Scientists are also studying the role of genetics and environmental factors in hyperuricemia and gout.

What Is Polymyalgia Rheumatica?

What Is Polymyalgia Rheumatica?

Polymyalgia rheumatica is a rheumatic disorder associated with moderate-to-severe musculoskeletal pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning or after a period of inactivity, and typically lasts longer than 30 minutes. This disorder may develop rapidly; in some people it comes on literally overnight. But for most people, polymyalgia rheumatica develops more gradually.

The cause of polymyalgia rheumatica is not known. But it is associated with immune system problems, genetic factors, and an event, such as an infection, that triggers symptoms. The fact that polymyalgia rheumatica is rare in people under the age of 50 and becomes more common as age increases suggests that it may be linked to the aging process.

Polymyalgia rheumatica usually resolves within 1 to 2 years. The symptoms of polymyalgia rheumatica are quickly controlled by treatment with corticosteroids, but symptoms return if treatment is stopped too early. Corticosteroid treatment does not appear to influence the length of the disease.

What Is Giant Cell Arteritis?

Giant cell arteritis, also known as temporal arteritis and cranial arteritis, is a disorder that results in inflammation of arteries of the scalp (most apparent in the temporal arteries, which are located on the temples on each side of the head), neck, and arms. This inflammation causes the arteries to narrow, impeding adequate blood flow. For a good prognosis, it is critical to receive early treatment, before irreversible tissue damage occurs.

How Are Polymyalgia Rheumatica and Giant Cell Arteritis Related?

It is unclear how or why polymyalgia rheumatica and giant cell arteritis frequently occur together. But some people with polymyalgia rheumatica also develop giant cell arteritis either simultaneously, or after the musculoskeletal symptoms have disappeared. Other people with giant cell arteritis also have polymyalgia rheumatica at some time while the arteries are inflamed.

When undiagnosed or untreated, giant cell arteritis can cause potentially serious problems, including permanent vision loss and stroke. So regardless of why giant cell arteritis might occur along with polymyalgia rheumatica, it is important that doctors look for symptoms of the arteritis in anyone diagnosed with polymyalgia rheumatica.

Patients, too, must learn and watch for symptoms of giant cell arteritis, because early detection and proper treatment are key to preventing complications. Any symptoms should be reported to your doctor immediately.

What Are the Symptoms of Polymyalgia Rheumatica?

In addition to the musculoskeletal stiffness mentioned earlier, people with polymyalgia rheumatica also may have flu-like symptoms, including fever, weakness, and weight loss.

What Are the Symptoms of Giant Cell Arteritis?

Early symptoms of giant cell arteritis may resemble flu symptoms such as fatigue, loss of appetite, and fever. Symptoms specifically related to the inflamed arteries of the head include headaches, pain and tenderness over the temples, double vision or visual loss, dizziness or problems with coordination, and balance. Pain may also affect the jaw and tongue, especially when eating, and opening the mouth wide may become difficult. In rare cases, giant cell arteritis causes ulceration of the scalp.

Who Is at Risk for These Conditions?

Caucasian women over the age of 50 have the highest risk of developing polymyalgia rheumatica and giant cell arteritis. While women are more likely than men to develop the conditions, research suggests that men with giant cell arteritis are more likely to suffer potentially blinding eye involvement. Both conditions almost exclusively affect people over the age of 50. The incidence of both peaks between 70 and 80 years of age.

Polymyalgia rheumatica and giant cell arteritis are both quite common, according to the National Arthritis Data Work Group. In the United States, it is estimated that 700 per 100,000 people in the general population over 50 years of age develop polymyalgia rheumatica. An estimated 200 per 100,000 people over 50 years of age develop giant cell arteritis.

How Are Polymyalgia Rheumatica and Giant Cell Arteritis Diagnosed?

A diagnosis of polymyalgia rheumatica is based primarily on the patient’s medical history and symptoms, and on a physical examination. No single test is available to definitively diagnose polymyalgia rheumatica. However, doctors often use lab tests to confirm a diagnosis or rule out other diagnoses or possible reasons for the patient’s symptoms.

The most typical laboratory finding in people with polymyalgia rheumatica is an elevated erythrocyte sedimentation rate, commonly referred to as the sed rate. This test measures inflammation by determining how quickly red blood cells fall to the bottom of a test tube of unclotted blood. Rapidly descending cells (an elevated sed rate) indicate inflammation in the body. While the sed rate measurement is a helpful diagnostic tool, it alone does not confirm polymyalgia rheumatica. An abnormal result indicates only that tissue is inflamed, but this is also a symptom of many forms of arthritis and other rheumatic diseases.

Before making a diagnosis of polymyalgia rheumatica, the doctor may order additional tests. For example, the C-reactive protein test is another common means of measuring inflammation. There is also a common test for rheumatoid factor, an antibody (a protein made by the immune system) that is sometimes found in the blood of people with rheumatoid arthritis. While polymyalgia rheumatica and rheumatoid arthritis share many symptoms, those with polymyalgia rheumatica rarely test positive for rheumatoid factor. Therefore, a positive rheumatoid factor might suggest a diagnosis of rheumatoid arthritis instead of polymyalgia rheumatica.

As with polymyalgia rheumatica, a diagnosis of giant cell arteritis is based largely on symptoms and a physical examination. The exam may reveal that the temporal artery is inflamed and tender to the touch, and that it has a reduced pulse.

Any doctor who suspects giant cell arteritis should order a temporal artery biopsy. In this procedure, a small section of the artery is removed through an incision in the skin over the temple area and examined under a microscope. A biopsy that is positive for giant cell arteritis will show abnormal cells in the artery walls. Some patients showing symptoms of giant cell arteritis will have negative biopsy results. In such cases, the doctor may suggest a second biopsy.

How Are They Treated?

The treatment of choice for both polymyalgia rheumatica and giant cell arteritis is corticosteroid medication, usually prednisone.

Polymyalgia rheumatica responds to a low daily dose of prednisone that is increased as needed until symptoms disappear. At this point, the doctor may gradually reduce the dosage to determine the lowest amount needed to alleviate symptoms. Most patients can discontinue medication after 6 months to 2 years. If symptoms recur, prednisone treatment is required again.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin*), also may be used to treat polymyalgia rheumatica. The medication must be taken daily, and long-term use may cause stomach irritation. For most patients, NSAIDs alone are not enough to relieve symptoms.

Even without treatment, polymyalgia rheumatica usually disappears in 1 to several years. With treatment, however, symptoms disappear quickly, usually in 24 to 48 hours. If prednisone doesn’t bring improvement, the doctor is likely to consider other possible diagnoses.

Giant cell arteritis is treated with high doses of prednisone. If not treated promptly, the condition carries a small but definite risk of blindness, so prednisone should be started as soon as possible, perhaps even before confirming the diagnosis with a temporal artery biopsy.

As with polymyalgia rheumatica, the symptoms of giant cell arteritis quickly disappear with treatment; however, high doses of prednisone are typically maintained for 1 month.

Once symptoms disappear and the sed rate is normal, there is much less risk of blindness. At that point, the doctor can begin to gradually reduce the prednisone dose.

In both polymyalgia rheumatica and giant cell arteritis, an increase in symptoms may develop when the prednisone dose is reduced to lower levels. The physician may need to hold the lower dose for a longer period of time or even modestly increase it again, temporarily, to control the symptoms. Once the symptoms are in remission and the prednisone has been discontinued for several months, recurrence is less common.

Whether taken on a long-term basis for polymyalgia rheumatica or for a shorter period for giant cell arteritis, prednisone carries a risk of side effects. While long-term use and/or higher doses carry the greatest risk, people taking the drug at any dose or for any length of time should be aware of the potential side effects, which include:

fluid retention and weight gain

rounding of the face

delayed wound healing

bruising easily

diabetes

myopathy (muscle wasting)

glaucoma

increased blood pressure

decreased calcium absorption in the bones, which can lead to osteoporosis

irritation of the stomach

increase in infections.

People taking corticosteroids may have some side effects or none at all. Anyone who experiences side effects should report them to his or her doctor. When the medication is stopped, the side effects disappear. Because prednisone and other corticosteroid drugs reduce the body’s natural production of corticosteroid hormones, which are necessary for the body to function properly, it is important not to stop taking the medication unless instructed by a doctor to do so. The patient and doctor must work together to gradually reduce the medication.

What Is the Outlook?

Most people with polymyalgia rheumatica and giant cell arteritis lead productive, active lives. The duration of drug treatment differs by patient. Once treatment is discontinued, polymyalgia may recur; but once again, symptoms respond rapidly to prednisone. When properly treated, giant cell arteritis rarely recurs.

What Research Is Being Conducted to Help People Who Have Polymyalgia Rheumatica and Giant Cell Arteritis?

Research is providing new information that will help scientists better understand polymyalgia rheumatica and giant cell arteritis. The following issues are being studied:

Causes and mechanisms: Researchers studying possible causes of polymyalgia rheumatica and giant cell arteritis are investigating the role of genetic predisposition, immune system problems, and environmental factors. In one study supported by the National Eye Institute, researchers are attempting to better understand the immunobiology of inflamed arteries and advance the understanding of events that initiate vasculitis. Other research funded by the National Eye Institute is using a mouse model of giant cell arteritis to examine interactions between the immune system and blood vessels, and to explain the tissue damage that results.

Prognostic indicators: By examining characteristics of people with and without the conditions, doctors are starting to understand some factors that are associated with both the disease, and its prognosis and manifestations. For example, one study has shown that women are more likely than men to have jaw involvement from giant cell arteritis, while men are more likely to have eye involvement that can lead to blindness.

Treatment: While treatment with prednisone is almost always effective for both conditions, the drug carries the risk of potentially serious side effects. For that reason, one area of investigation involves looking for treatments that are safe while still being effective. A study funded by the National Center for Research Resources is looking at whether high doses of intravenous corticosteroid drugs given at the time of diagnosis can control giant cell arteritis more quickly, make it possible to prescribe lower subsequent doses of oral steroids, and control the disease with fewer drug side effects than current prednisone regimens.

Longitudinal information: As part of the NIH-funded Rare Diseases Clinical Research Network, scientists participating in the Vasculitis Clinical Research Consortium are collecting clinical and laboratory information from patients with giant cell arteritis to follow the disease over an extended period of time. Data from these studies will be used to examine the genetics and causes of giant cell arteritis, find new ways to track disease and predict responses, understand how to treat patients, and much more.

What is Osteoporosis?

What is osteoporosis?

Osteoporosis literally means ‘porous bones’. Our bones are made up of a thick outer shell and a strong inner honeycomb mesh of tiny struts of bone.

Osteoporosis means some of these struts become thin or break. This makes the bone more fragile and prone to break. It often remains undetected until the time of this first broken bone.

Broken wrists, hips and spinal bones are the most common fractures in people with osteoporosis.

What causes osteoporosis?

Two types of cells are constantly at work in our bones.

One set builds up new bone while another set break down old bone. Up to our mid-20s the construction cells work harder building strength into our skeleton.

From our 40s onwards, the demolition cells overtake and our bones gradually lose their density as a natural part of ageing.

One in two women and one in five men over the age of 50 will break a bone, mainly because of osteoporosis. Exactly why this happens is still not fully understood. Research continues to build up a picture of the factors that influence our bones.

Who is at risk?

Our bone health is largely down to the genes we inherit from our parents.

But there are other factors that can put people at greater risk:

Women if they have had an early menopause or hysterectomy (before the age of 45)

Men if they have low levels of testosterone (known as hypogonadism)

People who have broken a bone after only a minor trauma (called a fragility fracture)

People who take corticosteroid tablets (for conditions such as asthma or arthritis)

People with a family history of osteoporosis, particularly if your mother has broken her hip

People with medical conditions which affect the absorption of foods, such as Crohn’s disease, coeliac disease or ulcerative colitis

People with medical conditions which leave them immobile for a long time

People who drink excessive amounts of alcohol

People who smoke

Women who are underweight or have developed an eating disorder

Osteoporosis can also affect children and young people and pregnant women. However, these conditions are extremely rare.

I think I might be at risk. Can I be tested for osteoporosis?

You cannot see or feel your bones getting thinner. Many people are unaware of any problems until they break a bone or start to lose height.

If you think you are at risk then discuss it further with your doctor. You may need a special scan which measures bone density, called a dual energy x-ray absorptiometry (DXA) scan. It is a simple, painless procedure and is recommended for those people considered at high risk of breaking a bone because of osteoporosis.

Osteoporosis diagnosed on a bone density scan does not always mean you have a high risk of breaking a bone at the time of the scan so a drug treatment is not always necessary or appropriate. Other factors, such as your age, will need to be taken into account.

If you have broken a bone because of osteoporosis there are a range of drug treatments. These will help to reduce your risk of breaking another bone. The way you live your life can also help.

The way we live our lives can have a major impact on the health of our bones. It's worth remembering that bones are alive and constantly changing. Old, worn out bone is replaced with new bone in a process called 'bone turnover'. A child's whole skeleton is replaced within about two years. In adults this process takes longer - about seven to 10 years. So while this is happening we need to give our bones a helping hand. We think our skeleton will provide a solid framework for life but it needs tender loving care just like our skin, hair or heart!

Can I prevent osteoporosis?

Our bone health is largely inherited from our parents. About 80 percent of our bone health lies deep within our bodies in our genes. Research reveals that a family history of the disease, particularly if your mother has broken a hip after only a minor fall, leaves you at greater risk of the same happening to you. But there are steps you can take to influence the 20 percent of bone health left in your hands! It doesn't sound much but it's still an important amount that can make a difference.



So what can I do?

Get physical!

There's not getting away from the fact that exercise is the best way to help your bones.

Bone boosters

Your skeleton grows stronger if you do weight-bearing exercise. This is any kind of physical activity where you are supporting the weight of your own body. Good examples are:

Jogging

Aerobics

Tennis

Weight lifting

Dancing

Brisk walking

A good way to boost your bones when you are younger is to do brief bouts of high impact exercise. This could be as simple as jumping up and down on the spot, which provides a useful jolt to the hip and spine. It is the impact when your feet hit the ground that can eventually strengthen these bones. Another type of bone-building exercise includes using weights, where the action of the tendons pulling on the bones seems to boost strength. But don't be put off, it could be as simple as lifting a tin of beans in front of the TV, which may help strengthen your wrist bones, a common site for broken bones due to osteoporosis.

Active lifestyles

If you have osteoporosis you may need to be careful of vigorous, high impact exercise but it's important to stay active and find something you enjoy. Gradually increasing the amount of physical activity you do at any age, even if you are in your 90s, will benefit your bones. Leading an active lifestyle will ensure you have good balance and co-ordination as well as develoing muscle strength. All these can reduce your risk of falling and therefore breaking a bone, particularly your hip. Good examples are:

Swimming

Gardening

Walking

Golf

Tai Chi

Healthy eating

It's important to tuck into bone friendly foods to provide the proper nourishment our skeleton needs. The body contains 1kg of calcium, 99 percent of which is stored in our bones. It is important we eat plenty of calcium but lots of other vitamins and minerals are also important. If you enjoy a wide variety of food you will get a mix of all the vitamins and minerals you need.

It's a good idea to avoid:

Too much protein - particularly animal protein such as meat and cheese. Excessive amounts of protein may upset the acid balance within the body which then takes calcium from the bones to neutralise it. Too many grain foods like cereal and bread may have the same effect, although how significant this is is unclear. Eating plenty of fruit and veg should keep your body's acid balance stable.

Lots of salt - high levels of sodium can increase the amount of calcium the body gets rid of through urine. Watch out for 'hidden' levels of salt in processed foods

Drinking lots of fizzy drinks - phosphate, in the form of phosphoric acid, is used to improve the flavour in a lot of fizzy drinks and too much can cause the body to use calcium to balance levels. While there is no hard scientific evidence about its effect on bone health it may be a good idea to only drink these in moderation, particularly for children who are still growing

Drinking too much caffeine - again, a high consumption of caffeine could affect the balance of calcium in the body. Try adding milk to your coffee to counteract this effect or try to limit your intake to one or two cups a day.

Letting your weight drop too low - being overweight is not good for general health but being underweight increases the risk of broken bones when you fall. In younger women severe weight loss may stop menstrual periods because hormone levels drop which can also increase your risk of breaking a bone.

What about dietary supplements?

If we eat a healthy, varied diet then we should be able to get all the vitamins and minerals we need from food. It's certainly a lot tastier than pills!
As we get older, we absorb nutrients less efficiently. Many older people also have smaller appetites so may benefit from supplements if they are getting insufficient nourishment from food. Studies have shown that calcium and vitamin D can help to cut the risk of broken hips in frail older people so this can be a prescribed drug treatment for this group.

Calcium and vitamin D supplements are often given to people on osteoporosis drug treatments.

Why is Vitamin D is important?

Vitamin D is vital to help the body absorb calcium. The main source is the sun through our skin which the body converts into Vitamin D and stores in our fat. In this way it can manufacture and store enough of the vitamin to see us through the winter months when the sun is not strong enough to have an effect. Most of us will get enough sun to help our bones if we get out and about in the summer without even thinking about it. But be careful not to burn.

Older people, those who do not go out much and people who cover up for religious or cultural reasons may become deficient and 400 iu (international units), or 10mg, a day is recommended.

Try to quit smoking

Smoking has a toxic effect on bone by inhibiting the construction cells from doing their work. It's another good reason to try to give up.

Drink moderately

Enjoying the odd glass of wine could actually help your bones. But drinking too much alcohol is damaging to our skeleton. It's always good for your general health to have alcohol free days as well. Be aware that drinking alcohol can make you unsteady and increase your risk of falling, and therefore breaking a bone.

What is Osteoarthritis?

Who Gets Osteoarthritis?

What Causes Osteoarthritis?

How Is Osteoarthritis Diagnosed?

How Is Osteoarthritis Treated?

How Can Self-Care and a “Good-Health Attitude” Help?

What Research Is Being Done on Osteoarthritis?

Osteoarthritis is a joint disease that mostly affects cartilage. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over each other. It also helps absorb shock of movement. In osteoarthritis, the top layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together. The rubbing causes pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, bone spurs may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space, which causes more pain and damage.
People with osteoarthritis often have joint pain and reduced motion. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs. Rheumatoid arthritis – the second most common form of arthritis – affects other parts of the body besides the joints. Osteoarthritis is the most common type of arthritis.




Who Gets Osteoarthritis?

Osteoarthritis occurs most often in older people. Younger people sometimes get osteoarthritis primarily from joint injuries.

What Causes Osteoarthritis?

The cause of osteoarthritis is unknown. Factors that might cause it include:

Being overweight

Getting older

Joint injury

Joints that are not properly formed

A genetic defect in joint cartilage

Stresses on the joints from certain jobs and playing sports.

How Is Osteoarthritis Diagnosed?

Osteoarthritis can occur in any joint. It occurs most often in the hands, knees, hips, and spine.
Warning signs of osteoarthritis are:

Stiffness in a joint after getting out of bed or sitting for a long time

Swelling or tenderness in one or more joints

A crunching feeling or the sound of bone rubbing on bone.

No single test can diagnose osteoarthritis. Most doctors use several methods to diagnose the disease and rule out other problems:

Medical history

Physical exam

X rays

Other tests such as blood tests or exams of the fluid in the joints.

How Is Osteoarthritis Treated?

Doctors often combine treatments to fit a patient’s needs, lifestyle, and health. Osteoarthritis treatment has four main goals:

Improve joint function

Keep a healthy body weight

Control pain

Achieve a healthy lifestyle.

Osteoarthritis treatment plans can involve:

Exercise

Weight control

Rest and joint care

Nondrug pain relief techniques to control pain

Medicines

Complementary and alternative therapies

Surgery.

How Can Self-Care and a “Good-Health Attitude” Help?

Three kinds of programs help people learn about osteoarthritis and self-care and improve their good-health attitude:

Patient education programs

Arthritis self-management programs

Arthritis support groups.

These programs teach people about osteoarthritis and its treatments. They also have clear and long-lasting benefits. People in these programs learn to:

Exercise and relax

Talk with their doctor or other health care providers

Solve problems.

People with osteoarthritis find that self-management programs help them:

Understand the disease

Reduce pain while staying active

Cope with their body, mind, and emotions

Have more control over the disease

Live an active, independent life.

People with a good-health attitude:

Focus on what they can do, not what they can’t do

Focus on their strengths, not their weaknesses

Break down activities into small tasks that are easy to manage

Build fitness and healthy eating into their daily routines

Develop ways to lower and manage stress

Balance rest with activity

Develop a support system of family, friends, and health care providers.

What Research Is Being Done on Osteoarthritis?

Osteoarthritis is not simply a disease of “wear and tear” that happens in joints as people get older. There is more to the disease than aging alone. Researchers are studying:

Tools to detect osteoarthritis earlier

Genes

Tissue engineering

A wide range of treatment strategies

Osteoarthritis in animals

Medicines to prevent joint damage

Complementary and alternative therapies

Vitamins and other supplements

Injection of hyaluronic acid (a natural part of cartilage and joint fluid)

Estrogen

Biological and structural markers (biomarkers) for osteoarthritis.