Juvenile Idiopathic Arthritis: Symptoms and Treatments

Juvenile Idiopathic Arthritis (JIA) is the most common type of arthritis in children where the body tissues are attacked by immune system which in turn results into the inflammation of joints.

Some Facts about JIA (Juvenile Idiopathic Arthritis)

• Juvenile Idiopathic Arthritis occur in children younger than 16 years of age
• More girls than boys get affected by this disease.
• Children in the group of 2 to 3 years are at the higher risk
• It is an autoimmune disorder; means, body’s own immune system attacks tissues in the joint
• In some cases JIA can cause significant joint tissue damage
• JIA is treatable, but it is important and necessary to seek treatment from the knowledgeable healthcare providers.

What do we mean by Juvenile Idiopathic Arthritis?

JIA or Juvenile Idiopathic Arthritis is most common form of arthritis in children and adolescents. It is Juvenile Idiopathic Arthritis in the context that is occurs before the age of 16 and idiopathic in the sense that there is no defined cause and arthritis refers to the inflammation of synovium of a joint. JIA is a non- infective, autoimmune inflammatory joint disease that lasts for about 6 weeks to 3 months. JIA may involve one or many joints and cause symptoms such as fevers and/ or eye inflammation.

What are the causes of JIA or Juvenile Idiopathic Arthritis?

As JIA is an idiopathic disease, it has no defined cause. Researches show that Juvenile Arthritis occurs when body’s immune system attacks its own healthy cells and tissues. Here, the immune system, instead of protecting the body from harmful bacteria and viruses, releases chemicals that damage healthy cells and tissues causing inflammation and pain. It is not known why this happens but environment and heredity factors seem to play a role. Moreover, certain gene mutations such as viruses may make a person more susceptible to environmental factors.

What are the potential sign and symptoms of JIA?

The potential signs and symptoms of JIA or Juvenile Idiopathic Arthritis may include:

• Limping; especially first thing in the morning or after a nap
• Swelling in lager joints
• Child may feel stiffness and appear clumsier than usual
• Swollen lymph nodes, rashes and fever
• Tenderness in the joints
• Weight Loss
• Fatigue or irritability
• Eye redness, blur vision and eye pain

What are the options available to treat (JIA) Juvenile Idiopathic Arthritis?

Along with prescribing the required medications; Doctors may recommend your child to a physical therapist or occupational therapist.  A physical therapist may help your child to keep his body parts flexible and will also help to maintain range of motion.

• Therapists may also make recommendations regarding the best exercises and protective equipments available.
• They may also use joint supports or splints to protect joints and to keep them in good functional shape as well.
• They will also use exercises to stretch soft tissues and build up muscles.
• Heat and cold therapies, TENS, soft tissue massage therapy may be used to relieve pain.
• To prevent joint damage and to improve movement, exercising plans; to make your muscles stronger and more flexible may be recommended.
• Physical therapists will also help to improve your posture and recommend exercises to strengthen the ‘core’ of your body.
• Physical therapist may refer you to a podiatrist who may provide insoles to support your feet and ankles and will also help to relieve knee and hip pain.
• Apart from the exercises, your child may be advised medicines like analgesics, NSAIDS, DMARDS etc to relieve other symptoms.

Contact Center for Advanced Orthopedics and Sports Medicine for the diagnosis and treatment of musculoskeletal pathologies or disorders. It is our topmost priority to provide utmost care and prompt treatment to our patients as per their needs and requirements.

Fall Prevention

Risk of fall increases with an increase in your age; whether you fall on the road, in the garden or home itself; falling is always a frightening and life-changing experience and it is all the more scary and stressful for the people of older age or those living alone. According to a survey made by Centers of Disease Control and Prevention (CDC), falls are one of the leading causes of fatal and non-fatal injuries among the people who are 65 years of age and older.

Falls can cause serious injuries including; head injuries, forearm and shoulder fractures, pelvic, hip and spine fractures.

Which risk factors make you more susceptible to fall related injuries?

There are varied numbers of environmental, personal and medical risk factors that can make you more prone to fall-related injuries. By recognizing these risk factors you can save yourself and as well your loved ones’ from fall-related injuries.

1. Medical Risk Factors may include:

• Defective musculoskeletal functioning
• Irregular Heartbeat
• Osteoporosis or Arthritis
• Blood Pressure fluctuation
• Urinary & bladder dysfunction
• Hip weakness & imbalance
• Loss of vision or hearing
• Medications’ side-effects

1. Personal Risk factors:

• Inappropriate footwear
• Lack of activity
• Excessive alcohol intake
• Poor diet and not drinking enough water

1. Environmental Factors:

• Wet or slippery surfaces
• Improper Lighting
• Cluttered pathways
• Tripping hazards by pets
• Insecure area rugs and all throw rugs

How can the life style modifications reduce the risk for falling?

You can reduce risk for falling by maintaining your health and staying physically active. You can make following changes in your life style and can save yourself from fall-related injuries:

• Get an annual eye examination
• Go for bone-density test annually; it will help you to recognize the earlier signs of osteoporosis.
• Get your blood pressure and cardiac evaluated annually
• Eat healthy diet with adequate dietary calcium and also consume Vitamin D from food and supplements
• Go for an annual physical and as well check with your doctors about the side-effects of your medications.

How can you make your home fall-proof?

Researchers are of the view that easy and simple changes at home can decrease risk of falling and fall-related injuries as well. By following the below listed fall-proofing tips, you can make your home fall proof and can also save your loved ones’:

1. a) In the bathroom

• Put a rubber mat or slip-resistant rug next to your bathtub
• Use a tough plastic sheet in the bathtub
• There should be grab bars on the shower wall
• Use non-shattering material to replace glass shower enclosures
• Keep nightlight on in the bathroom

1. b) In the kitchen:

• Clean up any liquids, grease or food spilled on the floor
• Foods, dishes and cooking equipments should be stored within reach. Avoid standing on chairs or boxes to access upper cabinets
• Make use of non-skid floor wax

1. c) The Stairways:

• Keep your stairs clutter-free i.e. no packages or boxes
• Lighting should be proper so that you can properly see top and bottom landings and each stair
• Discard all throw rugs; instead use a rubber or slip resistant backing near the bottom and top of the stairs
• To increase visibility, install contrast strip on the edge of each stair
• Handrails should be installed on the both sides of the stairway
• Loose handrails, stairway carpeting and wooden boards should be repaired immediately.

1. d) In the Bedroom:

• Lamp, flashlight and telephone should be placed near your bed
• Bedroom floor should be clutter free
• Clothes should be arranged in the closet
• A nightlight should be installed along the passage between your bedroom and bathroom
• Use bed or sleep on a bed that is easy to get in and out.

What do you if you fall?

If you fall at home, especially, when you are alone at home or have been injured as result observe the following guidelines:

• Instead of extending your arms, raise your arm to save your head
• Try that you fall on your side or buttocks, so that you can roll over naturally
• After you fall, do not get up with a sudden jerk or in wrong position or you could make the injury even worse
• Initially assess the situation and decide whether your are hurt
• If there is a couch or chair nearby, try to crawl along the floor to reach them & then try to get up
• Do not try to get up on your own if you are badly injured

Contact Center for Advanced Orthopedics and Sports Medicine for any of your musculoskeletal pathologies or disorders. We are dedicated to provide our patients with utmost care as per their needs and requirements.

Dislocated Knee: What to Expect?

Many contact and non-contact sports can cause dislocated knee among players. Knee dislocation is more common among women than men because the muscles stabilizing the knees and hips are weaker in girls than boys. Treating a knee dislocation is a straight forward procedure that rarely requires surgical interventions.

What do we mean by knee dislocation?

Knee dislocation occurs when there is lose of contact between the thigh bone and shin bone. Knee-dislocation is high energy traumatic injury. After the knee dislocates, it is needed to be reset into the proper position. Knee dislocation is associated with severe pain and inflammation.

What are causes of knee dislocation?

Various factors including the following can cause knee dislocation:

• Twisting of knee in an unnatural position
• Forceful blow to the knee
• Tight or weak muscles around the knee & hip
• Landing awkwardly on knee with a sudden bending and twisting

What are the signs and symptoms of dislocated knee?

The most common signs of dislocated knee include:

• Pain along the inside of your knee
• Deformity of knee
• Swelling around knee joint
• Popping and feeling of instability
• Continued pain along the medial ligaments
• Discoloration at the site of injury

What are the treatment options suggested to treat dislocated knee?

• First of all R.I.C.E. principle is followed to lessen the swelling and inflammation.
• Immobilization of knee is suggested until the swelling reduces.
• Use of knee brace may be recommended for first two to three weeks as it reduces stress on the damaged tissues.
• Your orthopedist may suggest using crutches to walk.
• Exercises to strengthen muscles around the knee may be suggested.
• Exercises restoring your range of motion and strengthening your quadriceps, hamstrings and core may be suggested.

Contact Center for Advanced Orthopaedics and Sports Medicine for any of the sports’ related musculoskeletal pathologies or disorders. It is our topmost priority to provide utmost care and prompt treatment to our patients as per their needs and requirements.

Play Springtime Sports Safely: Safety Tips and Injury Prevention Guidelines

With the spring weather rolling in; kids, youth and adults around the U.S. would indulge in spring sports including; baseball, lacrosse, tennis, soccer and track and field. There is no doubt that these outdoor activities would be beneficial for health after long winter hibernation but you can make it more fun and safe by following certain injury prevention guidelines. As April is the National Youth Sports’ Safety Month, Center for Advanced Orthopaedics offers practical tips for the athletes of every age-group that would help to prevent any sports’ related injury and would as well save them from the risk of being permanently sidelined:

• All the athletes, whether children or adults should go for general medical exam and an orthopedic screening to determine whether they are ready to play or there is a condition that may limit participation.
• Provide your medical history to the coaches or medical staff and tell them about the specific medical conditions, if any.
• Make sure to check all the sports’ related equipments to ensure that they are safe to play with and up to the manufacturers’ standard.
• Monitor the field, if you are playing a field or track sport. Always look out for divots, uneven surfaces, loose goal posts and other conditions that can affect your play.
• Be well-informed regarding the sign & symptoms of concussion; seek immediate medical aid if you suspect the one.
• Immediately report to coach or athletic trainer, if you experience any of the symptoms of exertional heat illness
• Make sure that there is a proper on-field medical-aid present in case of emergency or injury.
• Stretch and warm-up properly before the game. All the major muscles groups involved in game should be stretched properly.
• Stay properly hydrated with water or fluids containing electrolytes. Avoid caffeinated sodas, as caffeine can make your body dehydrated.
• Eat healthy and lean proteins’ rich nutritious diet including green leafy vegetables and milk.
• Rest and relax properly if you feel tired or any of your body part is hurting.
• Maintain some level of physical activity throughout the year. Working out even once or twice a week can prevent injury.
• Athletes who participate in year round sports or who play sports multiple days in a row; should take day-off to avoid burn out or over-use injuries and to rest their tendons and muscles as well.
• Seek medical help if you get hurt or injured. And make sure that your injuries are fully recovered before you return to the sport.
• Learn first aid yourself, it is the best way to manage any emergency before the medical assistance is provided. It is always helpful to keep a first-aid kit handy.
• Try to participate in more than one type of sport or activity. Athletes engaged in more than one type of sports tend to have fewer injuries.
• Consult your doctor for a multi-vitamin or mineral supplement. Vitamin D has been proved to improvise athletic performance & healing process, eliminate information and reduce joint pain.
• Remember to put on your protective gears like; bike helmets, wrist and elbow guards, pads and knee protection. Do not forget to put on braces and casts if prescribed.

Sports and outdoor activities are always beneficial for the health but also make safety the part of the picture. Contact Center for Advanced Orthopaedics and Sports Medicine for any of the sports’ related musculoskeletal pathologies or disorders. It is our topmost priority to provide utmost care and prompt treatment to our patients as per their needs and requirements.

Orthopedic Post-Operative Pain Management Techniques

Orthopedic surgeons make every effort to control and relieve pain after orthopedic surgeries like; knee replacements, hip replacements and repair of hip fractures etc. Pain management during rehabilitation is focused at maximizing recovery and mobilization, shortening the hospital stay and hospital costs and as well to heighten the patient-satisfaction.

Pain management regimens are not standardized rather they are tailor-made according to needs, medical, psychological and physical condition, age ,level of anxiety, extensive surgical procedure and personal preferences of the patients. These pain management regimens aim at reducing the dose of medicine in order to lessen their side-effects while providing the appropriate analgesic dose. Various minimally invasive and stat-of-art techniques, including the following, are used to effectively manage pain after orthopedic surgery:

• Transcutaneous Electrical Nerve Stimulation (TENS): Transcutaneous Electrical Nerve Stimulation is a device that transmits low-level electrical charges into the area having pain. This therapy is useful to relieve pain after surgery and pain related to fractures and sprains as well.
• Continuous Passive Motion (CPM): Through using Continuous Passive Motion technique, your joint is gradually moved in mechanical splint, in order to avoid stiffness and to increase range of motion after surgery. Continuous Passive Motion (CPM) technique helps to heighten the joint nutrition and as well prevent the scar-tissue formation and abnormal shortening of muscles around the joint.
• Ice, heat, electrical stimulation and ultrasound therapy is used to treat muscle aches and back pain after the surgery.
• Cryotherapy is used to reduce swelling and relieve pain in joints and soft tissues after the surgery.
• Occupational Therapy is used, where patients are educated to use various adaptive devices to ease their life after therapy. This also makes the patient self-reliant and reduces the chances of re-injury.

 Contact Center for Advanced Orthopedics and Sports Medicine, for the state-of -art treatment of any of your musculoskeletal injuries or problems. Our board certified and experienced surgeon uses leading-edge & least invasive surgical and non-surgical methods and techniques to provide quality care and treatment to the patients.

Legg- Calve Perthes Disease

Legg- Calve Perthes Disease is a childhood disorder affecting children between 4 to 10 years of age. This disease is more common among boys than girls. After 2 years of treatment, children normally return to their routine life without any major limitations.

What do we mean by Legg- Calve Perthes Disease?

Legg- Calve Perthes Disease (LCP or Perthes Disease) is a pathological condition affecting hip, where pelvis and thighbone meet in ball and socket joint. It is a temporary condition under which, blood flow supply to ball shaped head of thigh bone is temporarily lost, resulting into collapse of thigh bone. As the bone collapses or becomes flat, ball no longer moves smoothly in the hip socket and the area becomes inflamed and irritated.  The child may begin to limp with or without pain and there is reduced range of motion. Over a period of time, blood supply retraces back and new blood cells start replacing the dead ones gradually.

How is Legg- Calve Perthes Disease diagnosed?

 After your child’s through physical examination and taking notes of his medical history, your doctor of orthopedics may ask for diagnostic procedures including; x-rays, bone scans, MRI, arthrograms and blood tests.

How is Legg- Calve Perthes Disease treated?

Proper and adequate non-surgical or surgical treatment is prescribed to lessen the pain and help the femoral head to retain its shape. For the children under 6 years of age and usually for the children with less severe symptoms, non- surgical treatment options are adopted including:-

• Initially to help patient to regain his motion and reduce pain your doctor of orthopedics may suggest rest and limit the activities involving jumping and running.
• Anti- inflammatory medication is prescribed to lessen the swelling.
•  Bed rest in traction may be prescribed for some patients.
• Stretching exercises may be prescribed to retain the flexibility of hip and as well to keep the hip in socket.  
• If the doctor feels that your child need to avoid bearing weight on the involved hip, crutches are prescribed to protect hip joint.
• Casts may be prescribed to keep the femoral head with in the socket.
• Night- time brace may also be used to maintain hip flexibility .

Orthopedic Surgical Treatment

Children who are more than 6 years of age and who experience more severe symptoms and pain are advised surgical treatment. The surgical treatment aims at preventing dislocation or collapse of hip. Surgical treatment may include:-

• Contracture Release procedure is employed to lengthen the shortened tissues.
• Joint realignment is conducted where plates are used to hold the bones in place. Realignment of joint helps to restore the normal shape of hip joint.
• Surgery is performed to remove loose bits of bone and torn flaps of cartilages.

 Contact Center Of Advanced Orthopedics and Sports Medicine for any of your musculoskeletal pathologies and disorders. Our board certified surgeon goes over an extra mile to provide you with the care and treatment you require and deserve.

Greenstick Fracture: Symptoms, Causes and Treatment

Greenstick Fractures are more common among children than adults, as their bones are softer and flexible than the adults. At times, these fractures are difficult to be diagnosed and are taken as sprains, as they do not cause much pain and swelling.

What is a Greenstick Fracture?

When a young and soft bone instead of breaking up into different pieces; bends and cracks or breaks away partially, it is called Greenstick Fracture. These fractures usually occur during the infancy and childhood because the bones are soft and flexible during this period. In a Greenstick Fracture, only one side of the bone gets broken while the other one only bends. The term Greenstick Fracture is derived from the analogy of breaking up of a young, fresh and green tree branch.

What are the potential signs and symbols of Greenstick Fracture?

Following can be considered as the potential signs of Greenstick Fracture:

• Abnormally twisted limb
• Pain
• Swelling
• Decreased range of motion
• Inability to put weight on the affected limb

Moreover, arm fractures are more common than leg fractures because children usually throw open their arms when they start falling.

What are the causes of Greenstick Fracture?

Following factors result in the Greenstick Fracture:

• Falls while playing or participating in sports
• Blow on the forearm or shin
• Activities with high risk of falling

What are the treatment options available for treating Greenstick Fracture?

Bone fractures, even Greenstick Fractures needed to be immobilized to get healed and grow back together. Most of the fractures require 4-8 weeks for complete healing. Following treatment techniques are employed by the doctors of orthopaedics to treat Greenstick Fractures:

• Casts are used to keep the bones in good alignment during healing
• If the bones have  misaligned, doctors may have to reposition them before using casts
• Removable splints may also be used
• To reduce swelling, doctors may advise to raise the limb higher than the heart level

But once the cast is removed, make your child to avoid high impact activities for one or two weeks in order to avoid re-injury.

Contact Center of Advanced Orthopedics and Sports Medicine for the advanced and avant-garde treatment of any of your musculoskeletal problems. Our certified surgeon goes over an extra mile to provide you quality care and help you to regain your function and mobility.