Bone and Joint Health - Roel Tolentino, MD, MBA

This lecture will help you understand the more common bone and joint problems.

1. Bone and Joint
Roel Tolentino, MD, MBARoel Tolentino, MD, MBA , FACS, FPCS, FPSGS, FPSO, FMOSP
Surgical Oncologist
TV, Radio and Lay Health Educator
Surgery Professor Level IV

2. 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

3. Musculoskeletal
Diseases
Roel Tolentino, MD, MBARoel Tolentino, MD, MBA , FACS, FPCS, FPSGS, FPSO, FMOSP
Surgical Oncologist
TV, Radio and Lay Health Educator
Surgery Professor Level IV

4. To educate the audience on the different To educate the audience on the different
bone and joint problems.bone and joint problems.

6. Arthritis
Degenerative Joint Disease
Arthritis = joint inflammation.
Arthralgia= joint pain

7. Arthritis

8. Arthritis
Different types of arthritis:
Osteoarthritis
Rheumatoid arthritis
Gouty arthritis

9. Osteoarthritis
Most common form.
One or many joints undergo degenerative and
progressive changes.
Deformity, incomplete dislocation and synovial
effusion.

12. Osteoarthritis- Risk Factors
Age
Decreased muscle strength
Obesity
Possible genetic risk
History of trauma

13. 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

15. Osteoarthritis
Treatment: Treatment:
Rest
Heat
Anti inflammatory drugs
Decrease weight
Injectable corticosteroids
Surgery

16. Osteoarthritis - Treatment
Glucosamine - maintains health of cartilage

17. Auto-Immune Disease
Inflammatory and immune response are normally helpful.
BUT these responses can fail to recognize self cells and attack
normal body tissues.

18. Auto-Immune Disease
Can severely damage cells, tissues and organs
Rheumatoid Arthritis

21. Rheumatoid Arthritis
Chronic, systemic, progressive inflammatory
disease of the synovial tissue.
Can cause severe deformities that restrict
function

23. RA - Risk Factors
Female gender
Age 20-50 years
Genetic predisposition
Stress

24. Rheumatoid Arthritis -
Treatment
Rest, during day, decrease wt. bearing stress.
Maintain joint function, exercise, water
Medication
Immunosuppressive drugs

25. Gouty Arthritis

30. 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

32. Gouty Arthritis - Treatment
Analgesics/anti-inflammatory
Allopurinol
Modify diet

33. Osteoporosis

34. Osteoporosis
Metabolic bone disorder- progressively porous,
brittle, fragile bones, low bone density, susceptible
to fractures
Occurs in postmenopausal women
Loss of height

36. Osteoporosis - Risk Factors
Aging - over 80 yrs. old, 84% have
osteoporosis.
Family history
Postmenopausal estrogen deficiency

37. 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

38. Patient teachings
Adequate dietary calcium
Exercise, weight-bearing (beneficial)
Walking outdoors- vitamin D absorption.

39. Safe home environment, fall prevention
Balanced diet - protein, Mg, Vit K & D, Ca
Patient teachings

40. Modify lifestyle choices - smoking, alcohol,
salt and caffeine intake and sedentary
lifestyle.
Patient teachings

42. Patient teachings

43. Hormone Replacement Therapy
Bisphosphonates - Fosamax
Analgesics/anti-inflammatory
Patient teachings

44. Contusions, Strains, Sprains
Contusion - soft tissue injury, hematoma.

45. Contusions, Strains, Sprains
Strain- “muscle pull” over use over stretching.

46. Contusions, Strains, Sprains
Sprain – an injury to ligaments surrounding
joint, caused by twisting.

47. Contusions, Strains, Sprains
Management- RICE = rest, ice, compression,
elevation.

48. Orthopedic Injuries
Joint dislocation

49. Fractures

50. Hip fractures
High incidence in elderly due to risk for falls,
osteoporosis.

51. Back Pain

52. Back Pain

54. Back Pain

55. 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

56. Work comfortably:
&
vary your postureposture
often.

57. Working in Comfort
•Feet
•Flat on floor
•Head
•Up, not tilting back
•Facing forward

58. 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

59. Arranging Your Work Area
•Chair
•Desk/Workstation
•Monitor
•Keyboard & Pointing Device
•Papers & Books
•Telephone

61. Chair
•Adjustable
•Back support
•Stable base
supported by
legs with
casters

62. Desk/Workstation

•Sufficient work space
•Uncluttered
•Sufficient light

63. Monitor
•Positioned directly in front of you and at an
arm’s length away
•Screen top at eye level

64. Keyboard & Pointing Device
•Position keyboard & mouse just below elbow height
& at the same height
•Use a keyboard tray

65. Telephone
•Avoid cradling the phone
•Use a wireless head set or
speaker phone

66. Healthy Notebook Computing

67. Stretch Breaks
Take a break every 20 minutes

68. Hazards
ErgonomiErgonomi
c stressesc stresses
•Limited workspace
•Repetitive task
•Mental and physical
workload

70. Tumors of the musculoskeletal
system

71. Tumors of the musculoskeletal
system

72. Soft tissue sarcoma

73. Osteosarcoma

84. In Summary…..
Prevent bone and joint problems.
Consult your doctor for any health issues.
Take supplements: calcium; glucosamine