Alright doctor we were talking about osteoporosis I want to switch gears now to arthritis and this is alarming it’s a disease that affects an estimated 52.2 or 52.5 let me correct myself million adults in the United States Wow yeah that’s a huge number absolutely and that number may actually be underestimated really it may not account for a lot of people that have the disease and are really not symptomatic a lot about this disease that we still don’t understand unfortunately and is of course you know the subject of ongoing research but not everyone that has arthritis or that has osteoarthritis develop symptoms which is which is quite interesting and fascinating actually but I said it sees that affects millions and millions worldwide and of course you know it represents a significant burden not only for for the health of the patients we treat but also for for the for the healthcare system and in terms of spending now we all obviously you know have heard about arthritis we know about it but I’d like you to define it for me what is it so arthritis affects the cartilage in the joints it’s a disease that primarily and predominantly affects the covering of the bone the cartilage is kind of like the helmet to the bone is the way I like to describe it it’s a it’s a very smooth surface but it’s also tough perhaps not as tough as bone but it is hard and it’s it’s job is to dissipate friction and pressure inside the joint so when arthritis occurs that cartilage breaks down and degenerates so that starts exposing the bone under it and in many cases that result in an inflammatory response inside the joint so the model that we’ve seen perhaps traditionally of arthritis representing just good ol wear and tear may just be over simplistic because there’s definitely a very important inflammatory component in the joint and more than one mechanism for the development of the you