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By Nathan Wei

Ankle arthritis is one of the most common problems seen in a rheumatology office. While it is a relatively small joint complex, it is subjected to a great deal of stress because of the weight-bearing required with standing and walking.

Throw in the need to make forward and backward movements as well as side to side movements, it becomes clear that the stress placed on the bones, ligaments and tendons is tremendous. And that doesnt even account for the twisting and [pivoting motions that are often required during a typical day.

Because of this responsibility and location, ankles are probably injured more than any other joint complex.

Many different kinds of arthritis can affect the ankle. The most common are osteoarthritis. Osteoarthritis is a wear and tear type of arthritis. The cartilage that cushions the joint begins to wear away prematurely as a result of trauma and localized inflammation. This type of osteoarthritis that occurs following injury is referred to as post-traumatic osteoarthritis. A common scenario is someone who sprains their ankle as an adolescent or young adult and then develops ankle arthritis years later.

Rheumatoid arthritis comprises about 15 per cent of ankle arthritis. Rheumatoid arthritis is a chronic systemic autoimmune disease that affects virtually all joints. The chronic inflammation leads to progressive deterioration of cartilage, bone, and ligaments.

Other types of arthritis that can attack the ankle include psoriatic arthritis, Reiters disease, gout, pseudogout, sarcoidosis, juvenile arthritis, and ankylosing spondylitis.

Treatment of ankle arthritis first consists of making the correct diagnosis. That takes a careful history and physical examination. Laboratory testing and imaging studies such as x-ray, ultrasound, and magnetic resonance imaging are useful.

Treatment for mild discomfort is straightforward. Limit activities that cause pain. That means high impact sports like running, soccer, and basketball. If excess weight is an issue, then weight loss is mandatory. Over-the-counter anti-inflammatory medicines can also provide symptomatic relief.

Various ankle braces can be a lifesaver. These come in different varieties and shapes. They can fasten using laces or Velcro. Braces may be soft or may contain a hard synthetic shell. It is best to consult with your rheumatologist or orthopedist before purchasing a brace.

Orthotics are shoe inserts that tilt the ankle and relieve pain by altering the direction of stress forces. These should be custom-made for optimal results.

Rocker bottom shoes reduce pain with walking because they limit the amount of motion the joint has to go through. People who have had ankle fusion surgery 9where the joijt is fused together) often find rocker bottom shoes helpful.

When ankle pain is severe due to inflammation and/or fluid accumulation, then aspirating the joint with a needle and injecting a long-acting glucocorticoid (steroid) may be very useful. Following a procedure like this, it is a good idea for the patient to have their ankle braced for at least three days to rest the joint.

Physical therapy is also an excellent adjunctive therapeutic approach. The therapist can help the patient with different modalities that can reduce edema (soft tissue swelling0 as well as inflammation and also teach a patient exercises to strengthen and stabilize the ankle so that future ankle sprains and strains are less likely.

Patients who have severe ankle arthritis due to osteoarthritis may benefit from viscosupplementation. This is a procedure where a lubricant is injected into the joint. Viscosupplements have been used successfully in many joints including the knee, hip, and shoulder, as well as the ankle.

Surgery is an option for patients who have failed more conservative measures. Arthroscopy, which is a procedure where a small telescope is inserted into the ankle joint through a tiny incision. Small instruments are used to remove loose pieces of cartilage. This procedure can also be incorporated with simultaneous cartilage transplant where healthy cartilage is inserted in place of damaged cartilage at the time of the procedure. Cartilage transplant procedures are very time intensive and require limited weight bearing for several weeks to months afterward.

Joint realignment is a procedure where a wedge of bone is removed from one side of the ankle so that stress forces are transferred to the healthy part of the ankle. While this is a temporary fix, it is useful for some patients.

Ankle fusion is a surgical procedure where the tibia (leg bone) is screwed to the talus (upper ankle bone). This restores alignment and reduces pain. Unfortunately, the patient loses about half of the plantar and dorsiflexion (toe down and toe up) movement in the ankle. The ability to walk without pain is restored to the ankle; however, there is more stress placed on other weight-bearing joints such as the knee, which can lead to the development of osteoarthritis in these joints.

Ankle replacement is an increasingly popular option. In the past, ankle replacements werent that effective but technological advances have improved their success. Good candidates for ankle replacement are those who are older than 55 years of age, in good medial condition, have their weight in the normal range, and who dont engage in high impact activities either at work or during their leisure time.

About the Author: Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:

Arthritis Treatment

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By Linda D. Allen

Is a Rash on Your Skin a Sign of Yeast Infection? Learn about the Connection between Skin Rashes and Candida Infection

Are irritations and rashes of your skin evidence that you have a yeast infection? Before discussing the link between those symptoms and Candida infection, lets quickly look at what yeast infection is and how Candida infection can appear as common skin ailments, along with symptoms that are internal or external.

Yeast is the medical term for fungi which only have one cell. The type of yeast species which is often present in the human body is known as Candida, and the infections that can be caused by these microbes are then called yeast infections or candidiasis. In a healthy body, the flora in the intestines and a correctly operating immune system suffice to keep Candida under control. However if the friendly bacteria disappear, if the body is under severe stress, or if there is heavy intake of fat food which provokes candida infection, then the normal proportion of beneficial microbes and Candida is destroyed. Candida then over grows rapidly and becomes fungal in form to tear apart the tissue in the intestines, get into the blood circulation and then spread yeast infection all over the body.

Candida may affect the body as a whole and can also be seen locally. Yeast infection of the skin, also known as candidal skin infection, is one of the most frequent types of yeast infection, and can appear almost anywhere that there is a skin fold: beneath the arms, in the groin area, underneath the breasts, between toes, in the skins surrounding the fingernails, and also for those who are overweight under the folds of the skin of the abdomen.

For those people who do not have a strong immune system as for those who are under intense stress and all who persist in eating unhealthily (such as refined carbohydrates and yeasty foods that stimulate Candida overgrowth) are the most at risk to yeast infection. Oral contraceptives, antibiotics and medications that impact the immune system, together with excessive intake of alcohol, caffeine, refined carbohydrates and other processed foods can also depress the level of beneficial bacteria, encourage Candida and therefore increase the chance of candidiasis. Just for good measure, skin infection due to Candida on the toes may be linked with shoes that are tight fitting or closed-toe and very often afflicts those who participate in sports.

You need to identify several further symptoms if you want to make a good self-diagnosis of candidal skin infection, one that does not confuse it with other skin problems. Typical local symptoms include a rash which is red or brown in color and which can become crusty and ooze; cracking, or maceration of the skin; chronic wetness and soreness in skin folds; pain, burning and itching in areas that are affected and the presence of papules and pustules. When yeast infection is severe, local symptoms may then also act in conjunction with inner problems on a mental or emotional level including problems of digestion, allergies to food, bad breath, bloating of the intestines, swings in mood, tiredness, blurred vision, abnormal desire for sugar and other refined carbohydrates and so on.

For many years it was widely thought that yeast infections of the skin were all local and that they could be effectively cured using topical anti-fungal medications. Physicians still persist in treating skin candidiasis with such anti-fungal creams. However as weve already said, yeast infections are the result of internal factors and therefore to cure candida overgrowth and related symptoms requires more than just treating the visible external manifestation while neglecting the underlying causes. As well as this, if the underlying reasons that provoked to yeast infection are not treated, the disease can worsen and the related symptoms can degenerate even further.

Did anyone tell you that your yeast skin infection could be securely and safely treated with powerful holistic methods that are all-natural? Find out about the only way to effectively eliminate yeast infections of the skin using a long-term holistic program that works from within and prevents them from recurring ever again.

About the Author: Linda Allen is a health consultant and author of the #1 best-selling e-book

Yeast Infection No More

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Skin Yeast Infection

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byAlma Abell

Going to the dentist does not have to leave you in dread. When you have the right dentist to meet your needs and you know what to expect from your visit, you can feel at ease. This will prepare you for your visit so you can Experience Wichita Dentists, making sure your oral health needs are taken care of.

What Happens When You Visit the Dentist?

Maybe it has been years since you’ve been to the dentist and now you are a little nervous, not knowing what to expect. Though you may have neglected the health of your teeth, there is no reason to continue. Seeing the dentist as soon as possible can help him or her to find any dental issues you may have and get them corrected so you do not continue to suffer with damages and risk tooth loss.

When you first visit the dentist, you will need to make sure you bring in your insurance information and you answer all of the health questions asked of you. This will give the dentist the information needed, to make sure your dental needs are provided for. Once all of your paperwork has been filled out, you will be called back to have your teeth cleaned.

Having your teeth cleaned is typically a relaxing time for most people. The hygienist will clean your teeth, floss them and give you a fluoride treatment, to make them strong. Once your teeth have been cleaned, you will have X-rays taken, so the dentist can get a better look at the structure of your teeth and find any hidden issues.

During the examination process, the dentist will examine your teeth and look at your X-rays. If any issues are found, your treatment options will be discussed and scheduled. By making sure you get these issues corrected and then see your dentist at least twice a year, you can help to keep your smile healthy.

If you would like to Experience Wichita Dentists, contact the dental office of Gilbert Omido and make an appointment, so you can have your teeth cared for. There is no better time to get your teeth in the best shape possible.