Osteoarthritis is the most common form of arthritis. Often called wear-and-tear arthritis, it occurs when the protective cartilage on the ends of your bones wears down over time.
While osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, neck, lower back, knees and hips.
Gradually worsening with time, no cure exists. But treatments can slow the progression of the disease, relieve pain and improve joint function.
Symptoms often develop slowly and worsen over time with pain as joint may hurt during or after movement.
Joint may feel tender when you apply light pressure to it, and stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
The person may not be able to move his/her joint through its full range of motion and may hear or feel a grating sensation in body movement.
The extra bits of bone, which feel like hard lumps, may form around the affected joint.
Osteoarthritis occurs when the cartilage that cushions the ends of bones in the joints deteriorates over time.
Cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. The slick surface of the cartilage becomes rough.
Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone.
The risk of osteoarthritis increases with age.
Women are more likely to develop osteoarthritis while some people are born with malformed joints or defective cartilage, which can increase such risk.
Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis and carrying more body weight puts added stress on the weight-bearing joints, such as your knees.
Certain occupations that entail repetitive stress on a particular joint may eventually develop osteoarthritis.
Having diabetes, underactive thyroid, gout or Paget’s disease of bone can increase the risk of developing osteoarthritis.
Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make daily tasks difficult.
Some people are no longer able to work. When joint pain is this severe, doctors may suggest joint replacement surgery.
Salivary Gland Problems
Your salivary glands make as much as a quart of saliva each day. Saliva is important to lubricate your mouth, help with swallowing, protect your teeth against bacteria, and aid in the digestion of food.
The three major pairs of salivary glands are:
parotid glands on the insides of the cheeks; submandibular glands at the floor of the mouth; and sublingual glands under the tongue
There are also several hundred minor salivary glands throughout the mouth and throat. Saliva drains into the mouth through small tubes called ducts.
Many different problems can interfere with the function of the salivary glands or block the ducts so they can’t drain saliva.
The following are some of the more common salivary gland problems:
Salivary stones, or sialolithasis. The most common cause of swollen salivary glands, salivary stones are buildups of crystallized saliva deposits.
Sialolithiasis or salivary stones, is a condition where a calcified mass forms within a salivary gland, usually in the duct of the submandibular gland.
The usual symptoms are pain and swelling of the affected salivary gland, both of which get worse when salivary flow is stimulated, e.g. with the sight, thought, smell or taste of food, or with hunger or chewing.
The condition is usually managed by removing the stone, and several different techniques are available.
Rarely, removal of the submandibular gland may become necessary in cases of recurrent stone formation.
Sialolithiasis is common, accounting for about 50% of all disease occurring in the major salivary glands and causing symptoms in about 0.45% of the general population.
Sometimes salivary stones can block the flow of saliva. When saliva can’t exit through the ducts, it backs up into the gland, causing pain and swelling.
Pain is usually off and on, is felt in one gland, and gets progressively worse. Unless the blockage is cleared, the gland is likely to become infected.
Sialadenitis is a salivary gland infection.
Bacterial infection of the salivary gland, most commonly the parotid gland, may result when the duct into the mouth is blocked.
It creates a painful lump in the gland, and foul-tasting pus drains into the mouth and is more common in older adults with salivary stones.
But it can also happen in babies during the first few weeks after birth.
If not treated, salivary gland infections can cause severe pain, high fevers, and abscess or pus collection.
Viral infections such as mumps, flu, and others can cause swelling of the salivary glands.
Swelling happens in parotid glands on both sides of the face, giving the appearance of “chipmunk cheeks.”
Salivary gland swelling is commonly associated with mumps, happening in about 30% to 40% of mumps infections.
It usually begins approximately 48 hours after the start of other symptoms such as fever and headache.
Bacterial infections generally cause one-sided salivary gland swelling.
Other symptoms such as fever and pain will accompany the swelling.
The bacteria are typically those found normally in the mouth, as well as staph bacteria.
These infections most often affect the parotid gland.
Dehydration and malnutrition raise the risk of getting a bacterial infection.
Cysts can develop in the salivary glands if injuries, infections, tumors, or salivary stones block the flow of saliva.
Some babies are born with cysts in the parotid gland due to a problem with the development of the ears.
It can appear as a blister or soft, raised area.
Cysts may interfere with eating and speaking.
Most episodes of chronic parotitis are treated symptomatically.
Sialogogues, local heat, gentle massage of the gland from posterior to anterior, and hydration provide variable symptomatic relief.
When pus is expressed from the stensen duct, culture and sensitivity studies guide antibiotic selection.
Treatment of the primary disease is all that is required.
Some authors advocate intermittent irrigation of the ductal system with saline, steroid solution, and/or an antibiotic to treat the infection and mechanically remove inspissated mucous or pus from the ducts.
This may retard the disease progression. The rationale is stronger for those with the dilated “sausage-shaped” ducts.
This treatment is advocated for those patients not responding to symptomatic treatment and should be attempted before considering surgery.
Baurmash advocates a decadron (dexamethasone) and penicillin solution in saline to cleanse the ducts and for topical therapy.
If successful, this irrigation is repeated as needed.
Acute bacterial parotitis is caused by bacteria that ascends from the mouth and most frequently occurs in chronically ill patients.
Therapy may be altered based upon cultures or infectious disease consultation.