Biomech
5/21/99

Osteoarthritis
X-ray findings
1.	joint space narrowing—subchondral sclerosis (the bone becomes stronger, whiter, lots more blood vessels in the ends of the bone which are narrowed )
2.	osteophytes (spurs)—normal bone w/cartilaginous tip, increase surface area, can fuse to add stability
3.	Geodes (cysts, wholes in the bones), advance stages, black marks on the film at the end of the bone

Treatment
•	aspirin—increase bleeding in GI system, pain control in mild conditions, bleeding in the joint make deformed proteoglycans, speeds up the process of decay
•	corticosteroids—anti-inflammatory, inflammation is not one of the first symptoms, it is secondary, pain comes from periosteum of the bone, get fissures in the bone which can lead to blood vessesl that try to repair and nerves follow the blood vessels, drop the immune function, decreases bone mass and strength
•	Chondro protective agents (CPA)—helps repair and protect cartilage, glycosamine chondrotin sulfate
•	ROM w/o stress to keep moving the entire joint
•	chiropractic adjustments to avoid adhesions
•	substance P is made in the DRG and has a link to rhematiod arthritis
•	don't adjust inflamed joints, adjust the spine to affect the nervous system to help w/rhematiod arthritis in the fingers
•	MS—autoimmune disease, have episodes when stressed, stress suppresses the immune system