Date post: | 14-Apr-2017 |
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Bone and JointRoel Tolentino, MD, MBARoel Tolentino, MD, MBA, FACS, FPCS, FPSGS, FPSO, FMOSP
Surgical OncologistTV, Radio and Lay Health Educator
Surgery Professor Level IV
Memorial Sloan Kettering Cancer Center (NYC)University Hospitals of Columbia University and Cornell Medical College (NYC)MD Anderson Cancer (Texas)Beijing Cancer Hospital (China)Chongqing Medical University (China)Suining Central Hospital (China)
De La Salle University – De La Salle University – BS. Biology; BS. Biology; MedicineMedicine
Manila Med – Manila Med – General SurgeryGeneral Surgery
SLMC – SLMC – Surgical OncologySurgical Oncology
Ateneo GSB - Ateneo GSB - MBAMBA
Prof. Roel Tolentino, MD, MBA
MusculoskeletalDiseases
Roel Tolentino, MD, MBARoel Tolentino, MD, MBA, FACS, FPCS, FPSGS, FPSO, FMOSPSurgical Oncologist
TV, Radio and Lay Health EducatorSurgery Professor Level IV
To educate the audience on the different To educate the audience on the different bone and joint problems.bone and joint problems.
Arthritis Degenerative Joint Disease Arthritis = joint inflammation. Arthralgia= joint pain
Arthritis
Arthritis Different types of arthritis:
Osteoarthritis Rheumatoid arthritis Gouty arthritis
Osteoarthritis
Most common form.
One or many joints undergo degenerative and progressive changes.
Deformity, incomplete dislocation and synovial effusion.
Osteoarthritis- Risk Factors Age
Decreased muscle strength
Obesity
Possible genetic risk
History of trauma
Signs and Symptoms Joint pain and stiffness that resolves with rest
or inactivity
Pain with joint palpation
Crepitus in one or more joints
Enlarged joints
OsteoarthritisTreatment: Treatment:
Rest
Heat
Anti inflammatory drugs
Decrease weight
Injectable corticosteroids
Surgery
Osteoarthritis - Treatment Glucosamine - maintains health of cartilage
Auto-Immune Disease Inflammatory and immune response are normally helpful.
BUT these responses can fail to recognize self cells and attack normal body tissues.
Auto-Immune Disease Can severely damage cells, tissues and organs
Rheumatoid Arthritis
Rheumatoid Arthritis Chronic, systemic, progressive inflammatory
disease of the synovial tissue.
Can cause severe deformities that restrict function
RA - Risk Factors Female gender Age 20-50 years Genetic predisposition Stress
Rheumatoid Arthritis - Treatment
Rest, during day, decrease wt. bearing stress.
Maintain joint function, exercise, water
Medication
Immunosuppressive drugs
Gouty Arthritis
Gouty Arthritis Very painful joint inflammation, swollen and reddened
Inborn error of uric acid metabolism
Excess uric acid – converted to sodium uric acid crystals and precipitate from blood
deposited in: - joints - tophi - kidneys - renal calculi
Gouty Arthritis - Treatment Analgesics/anti-inflammatory
Allopurinol
Modify diet
Osteoporosis
Osteoporosis Metabolic bone disorder- progressively porous,
brittle, fragile bones, low bone density, susceptible to fractures
Occurs in postmenopausal women
Loss of height
Osteoporosis - Risk Factors Aging - over 80 yrs. old, 84% have
osteoporosis.
Family history
Postmenopausal estrogen deficiency
Osteoporosis - Risk Factors Low Calcium intake and low levels of Vit. D
Long tem steroid use
Lack of physical activity/prolonged immobility
History of smoking, high alcohol intake
Patient teachings
Adequate dietary calcium
Exercise, weight-bearing (beneficial)
Walking outdoors- vitamin D absorption.
Safe home environment, fall prevention
Balanced diet - protein, Mg, Vit K & D, Ca
Patient teachings
Modify lifestyle choices - smoking, alcohol, salt and caffeine intake and sedentary lifestyle.
Patient teachings
Patient teachings
Hormone Replacement Therapy
Bisphosphonates - Fosamax
Analgesics/anti-inflammatory
Patient teachings
Contusions, Strains, Sprains Contusion - soft tissue injury, hematoma.
Contusions, Strains, Sprains Strain- “muscle pull” over use over stretching.
Contusions, Strains, Sprains Sprain – an injury to ligaments surrounding
joint, caused by twisting.
Contusions, Strains, Sprains Management- RICE = rest, ice, compression,
elevation.
Orthopedic Injuries Joint dislocation
Fractures
Hip fractures High incidence in elderly due to risk for falls,
osteoporosis.
Back Pain
Back Pain
Back Pain
Ergonomics
“Science of workwork; of the peoplepeople who do it and the ways it is done; the tools and equipmenttools and equipment they use, the placesplaces they work in, and the psychosocialpsychosocial aspects of the working situation”
Pheasant, 1998
Work comfortably:
& vary your postureposture
often.
Working in Comfort• Feet
• Flat on floor
• Head• Up, not tilting back • Facing forward
Working in Comfort• Knees
• At right angle or greater• Free of edge of seat
• Arms• Relaxed by sides• Elbows at right angle
• Wrist (hands on keyboard)• Straight or slightly bent forward
Arranging Your Work Area• Chair• Desk/Workstation• Monitor• Keyboard & Pointing Device• Papers & Books• Telephone
Chair• Adjustable• Back support • Stable base
supported by legs with casters
Desk/Workstation
• Sufficient work space• Uncluttered• Sufficient light
Monitor• Positioned directly in front of you and at an
arm’s length away
• Screen top at eye level
Keyboard & Pointing Device• Position keyboard & mouse just below elbow height
& at the same height
• Use a keyboard tray
Telephone
• Avoid cradling the phone• Use a wireless head set or
speaker phone
Healthy Notebook Computing
Stretch BreaksTake a break every 20 minutes
Hazards
ErgonomErgonomic ic
stressesstresses
•Limited workspace•Repetitive task•Mental and physical workload
Tumors of the musculoskeletal system
Tumors of the musculoskeletal system
Soft tissue sarcoma
Osteosarcoma
In Summary…..
Prevent bone and joint problems.
Consult your doctor for any health issues.
Take supplements: calcium; glucosamine