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Arthritis: Who's At Risk?

Posted Aug 24 2008 1:49pm
DAVID MARKS, MD: Welcome to our webcast. I'm Dr. David Marks. Arthritis is a painful and sometimes debilitating condition. This disease of the joints affects 43 million Americans, and that number will only increase as the population ages. What is Arthritis, and who is at risk?

Joining us to explore these questions is Dr. Allan Gibofsky. He's Professor of Medicine and Public Health at Cornell, and a rheumatologist at the Hospital for special surgery. Welcome.

And next to him is Dr. Stephen Smiles, Clinical Assistant Professor of Medicine at NYU. Thanks for being here.

Who is at risk for arthritis? Is anybody at risk for arthritis?

ALLAN GIBOFSKY, MD: Everybody is at risk for arthritis, but there are different forms of arthritis. Some people are more at risk for some than for others. The older one gets, the more likely they are to have the degenerative form of arthritis from the abnormal use of a normal joint. Then there are forms of arthritis, which may occur as a result of infection. Those kinds of conditions may have a very definite genetic predisposition.

The long-winded answer to your question is that everyone is at risk at some time, and some people are at risk all the time. Again, our challenge is to identify what it is that is causing something to happen in the predisposed patient.

DAVID MARKS, MD: Let's talk about the advertisements for over-the-counter medications. Sometimes that's okay, but when should a person be concerned that they need to actually see a physician, that they can't self-medicate.

STEPHEN SMILES, MD: I think that once someone goes out, takes an over-the-counter medicine for what they believe is an ache and a pain, and in a relatively short period of time, be it a week, be it two weeks that they haven't had relief from having rest, an over-the-counter anti-inflammatory and/or analgesic. If changing their mode of activity has not relieved them from their pains, I think at that time they should go and seek some attention by their physician.

DAVID MARKS, MD: Are there any specific symptoms that would make your more concerned for a patient?

ALLAN GIBOFSKY, MD: Absolutely. The more acute and dramatic the presentation of the joint inflammation, the more concerned I am. So were you to call me and say that your elbow aches, I would be concerned. Were you to call me and say that your elbow has blown up like a balloon. It's hot and tender, and you're running a fever of 105, I would be even more concerned because that would suggest to me an acute infection, rather than a chronic process of the joint.

STEPHEN SMILES, MD: And along with that, if you then presented with more than one joint.

DAVID MARKS, MD: At the same time?

STEPHEN SMILES, MD: At the same time. Joints of the upper and lower extremity at the same time. One would believe that we were dealing with something other than just a traumatic type of process. That should make someone concerned and bring them to their physician.

DAVID MARKS, MD: Is there a genetic component to arthritis?

ALLAN GIBOFSKY, MD: Yes there is. There is excellent data to suggest that certain forms of arthritis run in the family and can be determined from certain kinds of blood tests on blood groups.

Rheumatic fever has a strong genetic predisposition. Lyme disease may have a genetic predisposition. The challenge though is that all of these genetic predispositions require an environmental trigger. We don't know what these triggers are yet, even though we're learning more and more about what kinds of things can interact in the genetically predisposed individual.

DAVID MARKS, MD: What are the three most common symptoms that a person should look for in arthritis?

STEPHEN SMILES, MD: The three most common symptoms would be pain in or around a joint, swelling in or around a joint, heat and redness in or around a joint.

DAVID MARKS, MD: Good. Well thank you very much, and thank you for joining our webcast. I'm Dr. David Marks. Goodbye.

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