LR V: MNT for Musculoskeletal Diseases

bones, cartilages, joints, and muscles;

ligaments and tendons.

The musculoskeletal system is composed of the __________, ___________, ____________, and _____________, together with associated structures such as _______________ and _______________.

considerable pain and disability;

deform the body

Musculoskeletal disorders can cause ____________ and ___________, and have the potential to _______________.

degenerative arthritis or degenerative joint disease

Osteoarthritis is formally known as ___________ or _____________, characterized by degeneration of joint cartilage.

joint aspiration,

x-ray,

MRI

(3) Tests used to diagnose osteoarthritis

joint aspiration

the test will look for infection or crystals in the fluid; results can help rule out other Medical conditions or other forms of arthritis.

x-ray

can show joint or bone damage or changes related

to osteoarthritis.

Magnetic resonance imaging (MRI)

gives a better view of cartilage and other parts of the joint.

Drug Therapy: NSAIDs, corticosteroids, topical and other

pain relievers

Health Behavior Changes: weight control, rest and relief from

stress on joints

Non-Drug Pain Relief: Heat and cold, TENS (transcutaneous

electrical nerve stimulation), massage

Medical Treatment for osteoarthritis

i. Balanced diet with appropriate kcal for weight

ii. loss or maintenance of appropriate weight

iii. Anti-inflammatory diet

iv. Supplementation with omega-3 PUFA

v. Adequate calcium and vitamin D

vi. Consideration of glucosamine and chondroitin

Nutrition Therapy for osteoarthritis

i. Exercise

ii. Acupuncture

Complement Therapy

Rheumatoid arthritis

an immunologic disease of the joints and related structures.

It is characterized by chronic autoimmune inflammation that begins in the synovial membrane and progresses to Subsequent damage in the joint cartilage

I. Blood test

II. Imaging ests like an X-ray, ultrasound or MRI

(2) Tests used to diagnose rheumatoid arthritis

Erythrocyte sedimentation rate (ESR, or "sed rate") and C-reactive protein (CRP) levels

are markers for inflammation. A high ESR or CRP combined with other clues to the disease

helps make the diagnosis.

Rheumatoid factor (RF)

an antibody found in about 80

percent of people with the disease.

i. Routine monitoring and ongoing care, doctor visits, blood, urine and lab tests, x-rays

ii. Drug Therapy DMARDS, biological response modifiers, analgesics,

iii. NSAIDs, corticosteroids

iv. Health Behavior Changes: Rest and exercise, Joint care, Stress reduction

v. Surgery: Joint replacement, tendon reconstruction, synovectomy

Medical treatment for rheumatoid arthritis

i. Healthful balanced diet

ii. Appropriate calories for maintenance of normal body weight

iii. Avoidance of possible food allergens

iv. Adequate B vitamins

v. Adequate protein, unless with malnutrition

vi. Adequate calcium and vitamin D

vii. Supplementation with ω-3 PUFA

viii. Anti-inflammatory diet*

ix. Intermittent fasting during acute phase

Nutrition therapy for rheumatoid arthritis

exercise, medication, tai chi, spirituality, relaxation techniques

complementary treatment for rheumatoid arthritis

Gout

a disorder of purine metabolism wherein abnormally high uric acid levels accumulate in the blood,

monosodium urate (MSU) crystals

Prolonged high levels of uric acid in the blood may cause build up or formation of needle-like ____________________.

If left untreated, recurrent attacks of gout will result in persistent swelling, stiffness, mild to moderate joint pain, and eventually permanent joint damage and disability

1. Joint fluid test - urate crystals in fluid is visible under a microscope.

2. Blood test - test for uric acid in the blood

3. X-ray

4. Ultrasound

The following tests are used to diagnose gout:

i. NSAIDs to relieve pain and reduce inflammation

ii. Glucocorticoids and colchicine to reduce inflammation

iii. Allopurinol

Pharmacological treatment for gout

1. Purine-restricted (100-150mg/day)

2. Omega 3 FA

3. Low fat, High CHO,

4. Fluid, 3L/day

5. Low kcal (obese); High kcal (underweight)

6. Alcohol-restricted

Dietary recommendations for gout

Axial skeleton

Appendicular skeleton

makes movement in the external environment possible

1/3 organic & 2/3 inorganic

matrix of bone tissue;

dry weight;

osteoporosis

the most common bone disease; severe loss of bone density; deterioration of bone microarchitecture.

DEXA (dual energy x-ray absorptiometry)

- measure bone mineral content and soft-tissue composition

- LBM and FM absorb the x-rays in different degrees, so that the percentage of each can be calculated

- reliable method

- Tissue densities are measured directly and are differentiated

- expensive and requires trained radiology

personnel.

* Generally limited to clinical studies

Paget's disease of bone

bone turnover is accelerated in localized areas