NSAIDs causes, symptoms, diagnosis & treatment


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Case Study of six years Old Male that Fell Out of a Tree and Broke his Ulna

Significance of Growth Plate

The growth plate is where the growth of the bones takes place and it is characterized by high metabolic activity with the regulation of various hormones and other signaling compounds. The growth plate has a lot of significance in children and teens and it determines the future length and shape of the mature bone (Ağırdil, 2020). The long bones consist of the bones in the lower limb which comprises the tibia, fibula,phalanges, and metatarsals. In the upper limbs it comprises for this case the ulna, metacarpals, and the phalanges.

Bone Formation

Bone development takes place through a series of synchronous steps which result in the formation of the body scaffold (Salhotra et al., 2020). Certainly, the repair potential of the bone and the surrounding microenvironment can persist to entire adulthood thus enabling the restoration of tissues to their functional state. 

Role of hormones 

The GH or the growth hormone is critical in growth. The gh+ hormones are operative at the pituitary gland and the gonads where they are responsible for the modification of metabolic and the growth impacts of growth hormone . Further PTH also stimulates the bone remodeling process( Ağırdil, 2020) PTH production is increased with the sole role of stimulating bone reception while at the same time liberating calcium from the skeleton. 

Various Types of structures

           The various types of structures play a critical role in bone development for instance we have osteoblasts, osteocytes, and the osteoclasts that all play an essential role in growth and the remodeling of the bones. In all three cells they all have a distinct capability for Instances osteoblasts are the bone forming cells, the osteocytes are for mature bones and the osteoclasts break down and reabsorb the bones. Therefore, all have distinct functions that aid in bone development.


Case Study 

A 65-year-old male presents with a painful left finger, he is unable to bend it and it is significantly swollen.  He has a history of osteoarthritis. 

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that enables nearly frictionless joint motion. Eventually, if the cartilage wears down completely, bone will rub on bone. Osteoarthritis has often been referred to as a wear and tear disease. But besides the breakdown of cartilage, osteoarthritis affects the entire joint. It causes changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone. It also causes inflammation of the joint lining (Mayo Foundation for Medical Education and Research. (2021, June 16). Osteoarthritis is a degenerative disease that worsens over time, often resulting in chronic pain. Joint pain and stiffness can become severe enough to make daily tasks difficult. Depression and sleep disturbances can result from the pain and disability of osteoarthritis (Mayo Foundation for Medical Education and Research. (2021, June 16). 

Bone spurs, or osteophytes, are smooth, bony growths, usually near joints. They develop over time in patients with arthritis or joint damage. The feet, hands, knees and spine often develop bone spurs. A healthy lifestyle can delay symptoms like pain, stiffness and limited motion (Bone Spurs (osteophytes): Causes, symptoms, diagnosis & treatment. Cleveland Clinic. (n.d.). A bone spur, also called an osteophyte, is a smooth, bony lump that grows off a bone. Bone spurs develop over long periods of time, usually near joints (where two or more bones meet). Bone spurs are most common in people 60 years or older, but younger people can get them, too. People with  osteoarthritis (OA) are much more likely to get bone spurs. OA is a common form of “wear and tear” arthritis that happens when cartilage, which cushions your bones, wears down (Bone Spurs (osteophytes): Causes, symptoms, diagnosis & treatment. Cleveland Clinic. (n.d.). 

NSAIDs are widely used to alleviate the symptoms of OA. It remains controversial as to what effects these agents have on the progression of OA. Preliminary clinical trials revealed some NSAIDs such as indomethacin had a negative influence on joint structure, other NSAIDs such as diclofenac and naproxen had no acceleration of radiographic damage to OA within 2-years of treatment. So far, there are no convincing data to show the widely used NSAIDs and recommended selective COX-2 inhibitor have favorable effects on cartilage. Therefore, it is necessary and valuable to clarify the effects of these NSAIDs on cartilage in patients with OA using validated non-invasive methods such as MRI (C;, D. (n.d.). 

The association between osteoarthritis (OA) and obesity is well established; widely acknowledged as a risk factor for both the incidence and progression of OA  1, obesity also has a negative influence on disease outcomes such as the need for surgery  2. Hence, weight loss, coupled with exercise, is recognized as an important approach in the management of obese patients with OA (Bliddal, H., Leeds, A. R., & Christensen, R. (2014, July).