In things it surprises me that more people don’t know

… the difference between rheumatoid arthritis and osteo-arthritis. I realised that my mother, who has a multi-joint arthritis problem, didn’t know the difference when she told me that a friend had recommended she avoid certain foods to help her arthritis, and I said “but Mum, you have osteo-arthritis, not rheumatoid arthritis – dietary triggers are not an issue for you” and she basically said “huh?”.

My mother is a cluey lady. She’s been battling joint pain and seeing physios and orthopaedic specialists for years now. Somehow not one of those medical professionals had managed to explain to her the difference between the two major types of arthritis and which one it was that she had. This is knowledge which would actually be useful, because the causes and therapies for different types of arthritis are so different that advice useful for one type can be actively damaging for those with the other type.

Arthritis refers to the deterioration of the articulating surfaces of the joints, and restricted range of joint motion due to stiffness and/or pain is the major physiological sign of the condition. But after that the symptoms vary significantly between the different forms or arthritis.

Osteo-arthritis is the most common form, and involves “wear and tear” – the joint surfaces deteriorate and end up as bone grinding on bone and possibly consequent misalignment of the joint surfaces, leading to more pains and restricted movements. Dietary restriction with the aim of weight loss is sometimes beneficial, but no particular foods need to be avoided in this condition.

Rheumatoid arthritis is an inflammatory condition, and involves the body’s immune system attacking the joint surfaces, causing pain, swelling and possible eventual deformity. The involvement of the immune system is where dietary restrictions of particular foods come into play in minimising flareups of the joint inflammation, although this only works for those subjects who do actually have food sensitivities.

If anyone’s not sure what type of arthritis they or a loved one has, one easy way to tell is by which medical specialist is overseeing their treatment – a rheumatologist or an orthopaedic surgeon. It’s not a foolproof sign – a specialist may decide to continue to treat you even after deducing that you’re not totally within their area of specialty, but it’s a fairly good sign. It is also, sadly, possible to have osteoarthritis in some joints and rheumatoid arthritis symptoms in others.

ETA: Here’s some useful arthritis information sheets.

So, that was my latest surprise on something that I really thought that at least most people who actually have arthritis could be expected to know. Have any of you been surprised by bumping up against unexpected gaps in what you thought would be common knowledge lately?

Categories: health, medicine


5 replies

  1. I keep bumping into administrative things that medical specialists and their staff expect me to know. A couple of examples: “but it’s a new calendar year, of course you need a new referral!” and “of course we don’t accept your X-rays/ultrasounds by courier, all our patients are required to hand deliver their films!”[1] I assume they are accustomed to patients who have been under specialist care for years.
    Stuff that I know that I assume is common knowledge but doesn’t seem to be is mostly computer stuff. There’s a few legal/tax kind of things. Like, even if you think/know that the ATO owes you a refund, that’s not a reason not to file an Australian tax return, I know a few people who’ve been surprised to find that “I was owed money anyway” is not an excuse. As a teenager someone I knew got stung by a jury duty call-up: he thought it was a kind offer from the local sherriff’s office to earn a bit of cash on the side, not that it was compulsory.
    I know that not everyone keeps track of which direction north is from where they are (it’s not innate as far as I know, it’s just something I take care to figure out/find out in a new area), but I do tend to be surprised when someone knows which way north is but then can’t figure out which direction is east. (And I have occasionally run into adults who are convinced the sun rises in the west, too.)
    [1] No one expects the Spanish Inquisition, or the patient without a car.

  2. Thinking about taxing things, I tend to make bad assumptions about what people do / don’t know about the distinction between income and cashflow, and capital vs revenue expenditure. I see the distinction so clearly and easily (back in the bad old days I was an accountant) that I forget that it’s not common knowledge.
    Keeping direction of north? Not a hope! I can work it out by thinking about what direction the sun rises from, and what direction it goes down in, but I don’t “know” where north is, and it’s no good telling me to go to the north side of a building. Can not compute. A number of times I’ve had to tell people quite explicitly that I really don’t understand where to go if they tell me to head to the north side of the city, or the north side of campus, or wherever. Having said that, the one time I was in the northern hemisphere, I was deeply confused by the sun being in the wrong direction in the sky – behind us, when we were heading north. So clearly I have some internalised sense of where north is, but it’s not good enough to guide me.

  3. The appropriate use of antibiotics! I really would have thought that the message that they aren’t of any use for viral infections would have got through by now, but I am still regularly advised to get antibiotics “just in case” or because “you seem sick enough”. I’ve even had doctors offer to prescribe them without any reason to suspect a bacterial infection.

  4. That you don’t get a cold from being cold.
    I was trying to interpret an email earlier this week in which the word “where” was spelled “were” and “their” was “there” the entire way through.
    Now I’m off to do my tax and figure out which way is north 😉

  5. Types 1 and 2 diabetes! My 10-year old granddaughter has recently been diagnosed with Type 1 diabetes and I can’t believe how many people (including scientists where I work) have told me that her parents must have let her eat too much junk food. (She was of course skinny as a rake, literally dying of starvation before her diagnosis.) As they live 30 kms from the nearest McDs or any other takeaway except fish-and-chips, grow most of their own veg, bake their own bread, and even eat their own home-killed meat sometimes, this is just ridiculous. The funniest moment for them so far was when the dietitian told R. under her new diet she could have a small serve of icecream once or twice a week. She turned to her mother, very excited, and said “Wow! She says I have to have icecream now!”

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