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USAHS Conditions Test 3 > Arthritis > Flashcards

Arthritis Flashcards

1
Q

Arthritic Conditions include…

A

Osteoarthritis (OA) and Rheumatoid Arthritis (RA).
-Affect the joints of the body in different ways and both types can limit a person’s ability to participate in occupations.

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2
Q

Arthritis Age Range

A

These conditions can occur at any age, but OTs typically work with older adults who have these conditions.

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3
Q

Osteoarthritis

A

The cartilage between the bones of a joint and slowly wears down over time creating pain, stiffness, and swelling in the joint

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4
Q

Rheumatoid Arthritis

A

An autoimmune condition in which the body attacks the joints, creating pain, swelling, and deformities.

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5
Q

Etiology of Rheumatoid Arthritis

A

Combination of genetic and environmental factors that leads to autoimmune reactions within the body.

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6
Q

If left untreated, arthritis autoimmune reactions result in the formation of…

A

Synovitis and tenosynovitis, which often lead to joint damage and ligament laxity.

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7
Q

What is the leading cause of disability in the US?

A

Arthritis

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8
Q

Arthritis Prevelance

A
  • Affects ~1% of the world population.

- Studies show it equally impacts all races, ethnic groups and gender.

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9
Q

Common Symptoms of Rheumatoid Arthritis

A
  • Polyarticular
  • Redness, warmth, and swelling of joints
  • Usually affects the same joint on both sides of the body.
  • Often causes a general feeling of sickness, fatigue, weight loss, and fever.
  • May develop suddenly within weeks or months, slowly, or individuals may experience exacerbations and remission.
  • Most often begins between ages 25 and 50.
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10
Q

Common Locations of Rheumatoid Arthritis

A
  • Hands and wrists
  • Elbow
  • Shoulder
  • Neck
  • Hip
  • Knee
  • Ankle
  • Toes
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11
Q

What distinguishes RA from OA?

A

In RA, typically multiple joints that are bilaterally affected and traces in cartilage-supporting bone tissues of a multiarticular joint, as evidence of the disease effect on the articular facets of the joint

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12
Q

Rheumatoid Arthritis: Stages of Inflammatory Disease Process

A

Acute> Subacute> Chronic-active> Chronic Inactive

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13
Q

Rheumatoid Arthritis: Common Deformities

A
  • Swan-neck deformity
  • Boutonniere deformity
  • Zig-zag deformity
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14
Q

Rheumatoid Arthritis: Impact on Occupation & Prognosis

A
  • Typically, function declines with severity of disease.
  • Those with arthritis tend to show fatigue, difficulty with fine motor ADLs, pain management; they will often need to make lifestyle changes.
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15
Q

Rheumatoid Arthritis Prognosis and impact on function depends on:

A
  • Number and length of remission
  • Levels of rheumatoid factor
  • Presence of subcutaneous nodules
  • Extend of bone erosion seen radiographically at the initial evaluation
  • Sustained disease activity
  • Energy Conservation & Joint Protection
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16
Q

Rheumatoid Arthritis Prognosis and impact on function depends on:

A
  • Number and length of remission
  • Levels of rheumatoid factor
  • Presence of subcutaneous nodules
  • Extend of bone erosion seen radiographically at the initial evaluation
  • Sustained disease activity
17
Q

Physicians typically focus on:

A
  • Relief of pain and joint stiffness
  • Reduction of edema
  • Preservation of normal joint function & soft tissue support structures
  • Minimization of the unintended consequences of the medication
  • Promotion of normal growth and development
  • Maintenance of ADL independence
18
Q

Early diagnosis and proper intervention of Rhematoid Arthritis

A

Before year 2 can halt the disease from progressing and some cases reverse disease progression.

19
Q

Medication: Rheumatoid Arthritis

A
  • Disease-Modifying Antirheumatic Drugs (DMARDs)

- Glucocorticosteroids (GCs)

20
Q

Osteoarthritis (OA) / Degenerative Joint Disease

A
  • OA is the most common type of arthritis.
  • Usually develops slowly over years due to repetitive use.
  • Causes inflammation of the bone and joint. OA affects cartilage, the tissue that cushions the ends of bones within the joints.
  • May initially affect joints asymmetrically.
  • Often affects hands and weight-bearing joints.
  • Can cause joint pain and stiffness
21
Q

Primary OA

A

Typical wear and tear associated with eroding the joint cartilage over time

22
Q

Secondary OA

A

Injury or insult to the joint, such as a fracture, that leads to premature erosion of the joint cartilage.

23
Q

Diagnosis of Osteoarthritis

A
  • Begins with a clinical exam due to a patient’s complaint of pain, stiffness, and swelling.
  • Severity of Osteoarthritis is diagnosed by x-ray or radiographs
24
Q

Common locations of OA

A
  • Fingers and Hands
  • Lower Back
  • Hip
  • Knees
  • Spine
25
OA Treatment
- Inflammation reduction | - Surgical & Medical Intervention
26
Inflammation Reduction (OA Treatment)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are used often. because they are effective at managing both inflammation and pain. - Rest - Activity modification
27
Surgical & Medical Intervention (OA Treatment)
- Cortisone shots - Total joint arthroplasty (Hip, knee, shoulder) - Spinal Fusion (for degenerative disc disease of the spine)
28
Activities that may cause increased stress on a joint
- Osteoarthritis is often caused by repetitive and stressful movements on a joint. - Occupational therapists often work with clients to identify which activities may be causing more joint inflammation and discuss how the client may modify those activities to prevent worsening of OA. - Please refer to the AOTA handout “Living with Arthritis” for some important tips on living with Arthritis.
29
Total Hip Arthroplasty (THA)
X-ray images of the right femoral neck fracture in a 65-year-old male patient with chronic renal failure before and after total hip arthroplasty.
30
Typical Movement Restrictions after Hip Surgery
- No hip flexion beyond 90 degrees, including movement of the trunk - No hip rotation (avoid internal rotation for posterolateral approach and eternal rotation for an anterolateral approach) - No crossing the operated leg over the unoperated leg - No adduction of the operated leg
31
Functional Implications after Hip Surgery
May impact one’s ability to do thing such as bathe feet, get in and out of a tub, don and doff socks, don pants, and functional transfers.
32
Total Knee Arthroplasty (TKA)
aka Knee replacement -A surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. Left: Damaged OA knee before and after prosthesis and TKA. -Right: X-ray of a knee replacement.
33
Total Knee Arthroplasty (TKA) Rehabilitation
Clients are typically weighted bearing as tolerated (WBAT) after surgery and have no limitations in range of motion.
34
Role of occupational therapy post knee replacement:
- Make recommendations for return to meaningful roles and occupations post surgery. - Provide recommendation for equipment upon discharge home. - Educate and train regarding functional tasks and transfers, i.e. dress the surgical side first when putting on pants.
35
Total Shoulder Arthroplasty (TSA)
A tremendously successful procedure for treating the severe pain and stiffness that often result at the end stage of various forms of arthritis or degenerative joint disease of the shoulder joint.
36
The primary goal of shoulder replacement surgery is...
- Pain relief, with a secondary benefit of restoring motion, strength, function, and assisting with returning patients to an activity level as near to normal as possible. - Many patients return to the sports they love like tennis, golf, and swimming, while also pursuing personal health initiatives such as individual training, yoga and pilates.
37
Painful shoulder arthritis refers to...
The disappearing of the normally smooth cartilage surfaces of the shoulder, which permit the ball and socket to smoothly glide against one another. This disappearance of cartilage covering results in a “bone on bone” joint and can be quite painful. Thus new surfaces provide the answer for restoration of comfort.
38
Degenerative Disc Disease & the Spine
- Usually in the neck or lower back. Can be due to OA or gradual deterioration with age. - Can result in radiating pain in arms, legs, thighs or buttocks - Pins & needles or reduced touch sensation due to pressure on the spinal cord. - Degeneration of the intervertebral disc which can cause pressure on the spinal cord. - This can be treated conservatively with activity modification or surgically with spinal fusion or decompression.
39
Spinal Precautions
- No bending - No twisting - No lifting anything more than about 5 pounds

USAHS Conditions Test 3 (22 decks)

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