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Dr. Gary S. Firestein, 4168 Front Street, San Diego, CA (2025)

04/01/2025

~Rheumatoid arthritis~
Rheumatoid arthritis is a chronic inflammation that occurs in the joints, usually in the wrists and fingers, and is an autoimmune disease (the immune system attacks its own tissues). Rheumatoid arthritis can strike people of any age, even children (juvenile rheumatoid arthritis). Women are more likely to develop rheumatoid arthritis than men. Rheumatoid arthritis is different from osteoarthritis because rheumatoid arthritis affects other parts of the body besides the joints, such as the eyes, mouth, and lungs.

03/13/2025

Psoriatic arthritis is similar to rheumatoid arthritis but does not produce antibodies specific to rheumatoid arthritis. Psoriatic arthritis occurs in about 20% of people with psoriasis (psoriasis is a skin disease that causes a scaly red rash and thickened, pitted nails). Carrying a specific gene (HLA-B27) and having a family history of the disease are high risk factors for psoriatic spondyloarthritis. The cause of psoriatic arthritis is unknown.
Symptoms of psoriatic arthritis
In psoriatic arthritis, joint inflammation often involves the small joints of the fingers and toes, but can also involve other joints such as the hips, knees and spine. The joints of the upper extremities are often more affected. Back pain may occur.
When the inflammation becomes chronic, the joints appear swollen and deformed. Compared to rheumatoid arthritis, psoriatic arthritis causes asymmetric joint lesions (more on one side of the body than the other) and involves fewer joints. Tendons or ligaments attached to the bones around the joints become inflamed (called tendon bone stop inflammation). Some people with psoriatic arthritis also suffer from fibromyalgia, which can cause muscle pain, joint stiffness and fatigue.
A psoriatic rash can appear before or after the onset of arthritis. Sometimes the rashes are not easy to spot because they are hidden in the scalp, belly button or within folds of skin, such as between the buttocks and between the thighs. Skin and joint symptoms can appear and disappear together. Sometimes skin symptoms are worse than joint symptoms, and sometimes joint symptoms are worse.

02/17/2025

~Ankylosing Spondylitis~
Ankylosing Spondylitis (AS) is a chronic inflammatory disease that affects the joints of the spine and pelvis. It belongs to a group of rheumatic diseases known as “spondyloarthropathies”, which usually result in inflammation of the joints of the spine, and in the long term may lead to fusion of the bones, resulting in stiffness of the spine and limitation of movement.
Common symptoms include:
Back and lower back pain: This is the most common symptom and usually begins as a nighttime or morning aggravation. As the disease progresses, the pain may gradually become persistent and restrict movement and rest.
Morning stiffness: When waking up in the morning, the patient often feels stiffness in the back or joints, making it difficult to move.
Joint inflammation: In addition to the spine, ankylosing spondylitis may affect other joints, especially the hips, knees and shoulders.
Fatigue: Patients often feel extreme fatigue, which may be caused by chronic inflammation or long-term joint pain.
Bone fusion: Over time, some parts of the spine may become fused, resulting in stiffness and limited range of motion.
Eye problems: People with ankylosing spondylitis may also develop inflammation of the eye (iritis), which can lead to redness, pain, and blurred vision.
Causes: The exact cause of ankylosing spondylitis is not fully understood, but genetic factors play an important role. About 90% of patients carry a gene called HLA-B27. In addition to genetic factors, environmental factors (e.g., infections) may also trigger the disease.

02/13/2025

~Gouty Arthritis~
Gouty arthritis, or simply gout, is an inflammatory joint disease caused by the deposition of urate crystals in the joints. Gout usually manifests as sudden onset of severe joint pain, redness, swelling and fever, especially in the joints of the big toe most commonly, but other joints such as the knees, ankles and hands may also be affected.
Causes of Gout:
The main cause of gout is high blood levels of uric acid, a waste product produced when the body metabolizes purines, a chemical found in certain foods. Uric acid is normally eliminated from the body through urine, but if it is produced in excess or excreted insufficiently by the kidneys, it can build up in the body, eventually forming crystals and depositing them in the joints, triggering inflammation.
Common symptoms of gout:
Severe joint pain: especially at night, the pain usually occurs in one joint and intensifies rapidly.
Swelling and redness of joints: Affected joints are usually swollen and the skin may become red and warm.
Fever: Some people may have a low-grade fever.
Duration of pain: gout attacks usually last from a few days to a week and may become more frequent and severe if left untreated.
Risk factors:
Diet: High purine foods such as red meat, seafood and alcohol (especially beer and spirits) increase uric acid levels, which can increase the risk of gout.
Obesity: obesity increases uric acid levels in the body.
Heredity: Gout has a tendency to run in families.
Age and gender: Men and middle-aged and older people are more likely to develop gout.
Kidney insufficiency: Decreased function of the kidneys to excrete uric acid may lead to accumulation of uric acid.
Preventive measures:
Dietary control: avoid high-purine foods, limit alcohol intake, and increase water intake to help uric acid excretion.
Maintain a healthy weight: Reducing body weight can help lower uric acid levels.
Regular checkups: Check uric acid levels in the blood regularly to detect and treat hyperuricemia.
Although gout is a treatable and manageable condition, if left unmanaged, recurrent attacks can lead to joint damage and long-term health problems. Prompt diagnosis and treatment is therefore essential to alleviate symptoms and improve quality of life.

01/23/2025

~Osteoarthritis~
Osteoarthritis and osteoporosis should not be confused. Osteoarthritis and osteoporosis are not to be confused. The latter is a condition that results from the loss of calcium from the bones and is prone to fractures.
Osteoarthritis (also known as degenerative arthritis) is a condition in which the cartilage wears out with age or overuse, causing pain. When the cushion-like protection of cartilage is missing, the bones begin to rub against each other, and the resulting friction causes pain and swelling.
Although osteoarthritis can occur in any of the joints, the symptoms are usually found in the hands, feet, spine and weight-bearing joints such as the knees and hips.
In the United States, osteoarthritis is the most common type of arthritis and one of the leading causes of chronic disability.
In 2005, about 27 million adults in the United States developed osteoarthritis. About 100,000 people were unable to walk due to severe osteoarthritis of the hip or knee. In the UK, 8 million people suffer from osteoarthritis.
Osteoarthritis gets worse over time and so far there is no cure. Treatment can go some way to help relieve the pain and allow the sufferer to maintain an active life. Conventional osteoarthritis treatments often use non-steroidal anti-inflammatory drugs (NSAIDs); while NSAIDs can relieve pain, they do not stop the progression of osteoarthritis. In addition, these medications can cause stomach problems.

01/23/2025

🔥 What's New in Knee “Clicking” Research: What to Think About Knee “Clicking”?
Knee “clicking” or “rustling” is a sound that occurs when the knee joint moves, which may or may not be accompanied by pain. Many people are concerned about this, fearing it is a sign of an underlying condition. The following is a compilation of a recent BJSM study to help us better understand this common but controversial phenomenon.
🦵 Confusing sources: Some studies suggest that knee clicking is harmless, but others suggest that it may be an early sign of Osteoarthritis (OA) of the knee.
🦵 Patient Concerns: Many patients have catastrophic thoughts about the sound of their knee joints, which affects their daily activities and their willingness to rehabilitate. In interactions with healthcare professionals, patients often feel that their concerns have not been adequately explained to them.
🦵 Controversy over diagnostic value: Although clicking is included in international guidelines for the diagnosis of osteoarthritis of the knee, it is also found in people without pain or structural lesions, which has led to a debate about the diagnostic value of this condition.
👨‍⚕️ How was the study conducted?
A systematic review and meta-analysis was used to screen 103 studies that included 36,439 participants (42,816 knees).
📊 Findings
General Population: 41%
Healthy control group with no injury and no pain: 36
Patients with osteoarthritis of the knee: 81 percent
Other musculoskeletal disorders of the knee: 35%-61
👨‍⚕️ association of structural lesions:
Those presenting with knee clicking were more than three times more likely to be diagnosed with x-ray osteoarthritis.
On imaging, clicking is associated with features such as bone spurs (Osteophytes), cartilage damage and bone marrow lesions.
✅ Key findings and clinical recommendations
Common but not always harmful
Knee clicking is quite common in the general population, even in more than one-third of healthy individuals.
Associated with osteoarthritis
Although there is a significant association between clicking and osteoarthritis and other structural lesions of the knee, this does not necessarily mean that there is a lesion or cause for concern.
Key Points for Communication with Patients
When a patient mentions knee clicking, explain that it is a common phenomenon and not necessarily a sign of pathology. Although associated with a structural lesion, it is not necessarily the direct cause of pain or dysfunction, and the patient can still safely participate in most daily activities and sports.

01/20/2025

UC San Diego Health Medical Offices South

About Our Clinic
View driving directions, parking information, phone numbers, and medical services for our UC San Diego Health clinic on Front Street in San Diego's Hillcrest.

01/14/2025

Symptoms and Causes
There are more than 100 types of arthritis, but they share several common signs and symptoms.
The most common signs and symptoms of arthritis usually affect your joints and your ability to use them.
The most common arthritis symptoms and signs include:
Joint pain.
Stiffness or reduced range of motion (how far you can move a joint).
Swelling (inflammation).
Skin discoloration.
Tenderness or sensitivity to touch around a joint.
A feeling of heat or warmth near your joints.
Where you experience symptoms depends on which type of arthritis you have, and which of your joints it affects.
Some types of arthritis cause symptoms in waves that come and go called flares or flare-ups. Others make your joints feel painful or stiff all the time, or after being physically active.

01/14/2025

Overview of Arthritis
"Arthritis" literally means joint inflammation. Joints are places where two bones meet, such as your elbow or knee.
There are many different types of arthritis with different causes and treatments. In some types, other organs, such as your eyes, heart, or skin, can also be affected.
Common symptoms of arthritis include pain, redness, heat, and swelling in your joints.
If you have arthritis, it is important for your doctor to diagnose the type of arthritis you have so that you can get the proper treatment. Fortunately, current treatments allow most people with arthritis to lead active and productive lives.

01/14/2025

United States Pharmacopeia (USP)

A independent, nonprofit organization dedicated to setting and promoting quality standards for medicines, dietary supplements, and food ingredients. Its standards are widely recognized and adopted around the world. USP certification ensures that products meet rigorous safety, purity, and quality requirements, offering consumers a trustworthy guarantee.

We are proud to announce that

It has been recommended by the United States Pharmacopeia (USP). This product has undergone rigorous quality testing and meets the high standards of the United States Pharmacopeia for pain relief and bone health. The USP recommendation reflects a high level of confidence in the quality and safety of our products, and you can be assured of reliable results and comfort when you choose our Joint Repair Gel.

Dr. Gary S. Firestein

04/01/2025

03/13/2025

02/17/2025

02/13/2025

01/23/2025

01/23/2025

01/20/2025

01/14/2025

01/14/2025

01/14/2025

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