as exfoliative dermatitis and renal
damage are not met with in practice. Agra-nulocytosis has
To start with, in a case of Rheumatoid arthritis
antibiotics are administered for 5-6 days to combat any infection.
Then phenylbutazone 200 mgms twice a day along with antacids
or Indomethacin 25 mgms to 50 mgms thrice daily is administered.
Reduced salt intake is advised during administration of butazolidine.
If butazoli- dones are not acceptable to the patient, Ibuprofen
is administered. Physiotherapy prevents atrophy of muscles.
Steroid therapy is to be deferred due to complications as
rarefaction and proximal myopathy.
Other joint disorders
These are rather uncommon. Gout, collagen
disorders as lupus erythematosus, colitis, tuberculosis, malignancy,
polymyositis may cause joint diseases. Penicillin, Procainamide
and dilantin cause joint disorders too.
This is a degenerative arthritis of the lower
cervical spines. It is a disease of old age and frequently
occurs in weight lifters, in lorry drivers and those who practice
yogasana. Sudden jolting of the body and neck causes strain
and minor trauma leads on to oedema of the cartilage. Cartilage
dehydration is also seen. There occurs alteration in the electrolyte
content of the cartilage. Mucopolysaccharide formation is
less. Annulus fibrosus gets ruptured and the soft nucleus
pulposus protrudes posteriorly. The fibroblastic reaction
of the dura results in a fibrous bend which interferes with
the circulation. Or Ligamentum denticulatum is fibrosed, and
movements of the spine do not produce movements of the spinal
cord and hence pain. Fibrosis of the perineurium causes radiculopathy.
Cervical spondylosis can present with (i) radicular pain with
atropy of muscles but with power retained till the last (ii)
progressive compressive paraplegia and (iii) acute over chronic
picture when a symptomatic cervical spondylosis is complicated
by trauma. A low plantar extensor is significant. Myelography
proves the diagnosis. Some develop symptoms of vertebro-basilar
insufficiency on turning the neck. Laminectomy and removal
of the damaged cartilage is the treatment of choice.
(i) Low backache
It is common in osteoporosis and degenerative
arthritis involving lumber spines. In women, pelvic pathology
has to be excluded. If pain occurs during rest, a non- osteoporotic
and a non-degenerative arthritic joint disorder is thought
of. Pain is action oriented (as assuming erect posture) in
osteoporosis. Pain during specific movements as bending, lifting
weight and when associated with neurologic deficits as numbness
of feet, pain radiating over the back and clawfoot is due
to degenerative arthritis.
(ii) Pain in the knee and or ankle
Degenerative arthritis is the commonest cause.
Particular movements as squatting cause pain. There is crepitus
and restriction of movements. Obesity is often associated.
Degenerative arthritis picks up certain joints. When knee
and ankle joint pain is