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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
Q

OA Treatment

A
  • Inflammation reduction

- Surgical & Medical Intervention

26
Q

Inflammation Reduction (OA Treatment)

A
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are used often. because they are effective at managing both inflammation and pain.
  • Rest
  • Activity modification
27
Q

Surgical & Medical Intervention (OA Treatment)

A
  • Cortisone shots
  • Total joint arthroplasty (Hip, knee, shoulder)
  • Spinal Fusion (for degenerative disc disease of the spine)
28
Q

Activities that may cause increased stress on a joint

A
  • 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
Q

Total Hip Arthroplasty (THA)

A

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
Q

Typical Movement Restrictions after Hip Surgery

A
  • 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
Q

Functional Implications after Hip Surgery

A

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
Q

Total Knee Arthroplasty (TKA)

A

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
Q

Total Knee Arthroplasty (TKA) Rehabilitation

A

Clients are typically weighted bearing as tolerated (WBAT) after surgery and have no limitations in range of motion.

34
Q

Role of occupational therapy post knee replacement:

A
  • 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
Q

Total Shoulder Arthroplasty (TSA)

A

A tremendously successful procedure for treating the severe pain and stiffness that often result at the end stage of various forms ofarthritisor degenerative joint disease of the shoulder joint.

36
Q

The primary goal of shoulder replacement surgery is…

A
  • 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
Q

Painful shoulder arthritis refers to…

A

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
Q

Degenerative Disc Disease & the Spine

A
  • 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
Q

Spinal Precautions

A
  • No bending
  • No twisting
  • No lifting anything more than about 5 pounds

USAHS Conditions Test 3 (22 decks)

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