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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).
Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
The aim of the diagnosis is to differentiate the diseases against other types of arthritis to avoid misdiagnosis and to rule out the other (secondary osteoarthritis)causes of osteoarthritis (OA)(104).
After taking the complex physical examination and careful exam the physical symptoms such as, joint swelling, Joint tenderness, decreased range of motion in joints, Visible joint damage, etc. some of the below tests may be necessary.
1. Blood Test
Although blood test is not necessary in many cases of osteoarthritis (OA), it can be helpful tool to rule other causes of the disease, including rheumatoid arthritis as it will indicate an inflammatory process(erythrocyte sedimentation rate (ESR, or sed rate) such as the presence of anti-cyclic citrullinate d peptide (anti-CCP) antibodies(105).
2. Synovial fluid analysis
Synovial fluid analysis is the test to exam the joint synovial fluid for conditions involving joint inflammation, pain, swelling, and fluid accumulation(106). Abnormal joint fluid may comprise abnormal amounts of detrimental bioactive proteins, temporary clearance, dilution or suppression/modulation as an indication of inflammation or osteoarthritis(107).
X rays beside is one of the common used to diagnosed for findings of osteoarthritis (OA) such as abnormal joints, bone, joint space between adjacent bone, loss of joint cartilage, etc., Accordning to the Framingham study, according to radio graphics, the prevalence of meniscus damage in the knee of subjects with no, one to two, and three or more finger joints with OA was 24.9%, 31.7%, and 47.2%, respectively. X-rays can show damage, other changes associated to osteoarthritis and to confirm the diagnosis(108)
4. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is a more sensitive imaging method, it is used less often than x-rays due to cost and availability. In conjunction of X ray for Osteoarthritis (OA), MRI has been used increasingly in recent years through a meta-analysis of published studies, according to Tufts University, School of Medicine(109) MRI scans show cartilage loss, damage and defects, bone size, bone marrow lesions, bone expansion and damage to ligaments(110).
The Misdiagnosis and delay diagnosis
Although musculoskeletal disorders is very common with irreversible damage due to osteoarthritis in elder found in evidences of all X ray, misdiagnosis is rare but it can happen. According to the Mount Sinai Medical Center, potentially reversible causes of osteoarthritis for the problem are too often ignored, and a misdiagnosis of osteoarthritis prevents or delays effective treatment of the actual underlying problem(174).
According to Dr. O'Duffy JD., there was a diagnostic problems of rheumatic disease in patients over 60 years of age, including patient with osteoarthritis, and these problems can be prevent if the doctors have taken accounted the history and physical examination alone, with the laboratory and x-ray findings providing supportive evidence(175).
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Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca p/general-health.htmlReferences
(104) Osteoarthritis Diagnosis(Spine health)
(105)The Pathogenesis of Rheumatoid Arthritis: Pivotal Cytokines Involved in Bone Degradation and Inflammation by CLIFTON O. BINGHAM III(The Journal of Rheumatology)
(106) Biologic basis of osteoarthritis: state of the evidence. by Malemud CJ1.(PubMed)
(107) Diverse expression of selected cytokines and proteinases in synovial fluid obtained from osteoarthritic and healthy human knee joints by Sauerschnig M1,2, Stolberg-Stolberg J3, Schulze A4, Salzmann GM5, Perka C6, Dynybil CJ7.(PubMed)
(108) Osteoarthritis Diagnosis(Arthritis foundation)
(109) The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis. by Menashe L1, Hirko K, Losina E, Kloppenburg M, Zhang W, Li L, Hunter DJ.(PubMed)
(110) How important is MRI for detecting early osteoarthritis? by Changhai Ding*, Flavia Cicuttini and Graeme Jones(Natrue Clinical Pratctice Rheumatology)
(174) Osteoarthritis as a misdiagnosis in elderly patients by Spiera H1.(PubMed)
(175) Differential diagnosis of rheumatic disease in the elderly by O'Duffy JD(PubMed)