ABSTRACT
This chapter introduces the two commonest forms of joint disease, namely osteoarthritis (OA) and rheumatoid arthritis (RA). The limb joints are among the wonders of human structure and function. OA is due mainly to life's wear and tear - it is degenerative joint disease and so is commonest in older people. Pain relief in OA should begin with oral paracetamol, raising the dose as required to 1 gram, four times daily. The high-potency synthetic oral steroid, prednisolone, is sometimes given in the management of RA, to reduce joint inflammation while the disease-modifying anti-rheumatic drug (DMARD) is starting to work. Response to DMARD treatment is assessed as a reduction in the erythrocyte sedimentation rate or C-reactive protein. However, in both osteoarthritis and rheumatoid arthritis there is a breakdown of normal joint structure and function, with progressive loss of function, pain and stiffness.
