Arthritis Flashcards
Epidemiology
0.8% of adult population with onset beginning between ages 30-80 years
Rheumatoid arthritis
Epidemiology
Most common arthropathy in adults
Osteoarthritis
Degenerative changes with progressive loss of cartilage and hypertrophic changes in surrounding bone
What is osteoarthritis
Chronic, inflammatory, systemic autoimmune disease.
What is rheumatoid arthritis
Who gets osteoarthritis
Who
Most common in older people, women>men; risk factors = obesity, family history, metabolic disorders, neuromuscular dysfunction
Who gets rheumatoid arthritis
Peak incidence in young adults; more common in women
When are symptoms present in osteoarthritis
When are symptoms present
Joint pain worsens with activity and improves with rest, worse in the evening. Stiffness is experienced more in the evening and after sitting for extended periods
When are symptoms present in rheumatoid
When are symptoms present
Morning stiffness greater than one hour.
Where is the pain of osteoarthritis located
Where is the pain located
Variable; asymmetrical distribution: hands, knees, hips
Where is the pain of rheumatoid arthritis located
Where is the pain located
Symmetrical; smaller joints affected first, as disease progresses other joints affected. Deformity is common.
Diagnostic Tests/P.E. for osteoarthritis
Diagnostic Tests/P.E.
None; may see Herbeden nodules on exam, bony enlargement, joint instability, restricted movement. Osteophytes on x-ray.
Diagnostic Tests/P.E. For rheumatoid arthritis
Diagnostic Tests/P.E.
Rheumatoid Factor, enzyme assays, CRP, ESR, CBC, and x-rays used to stage disease.
Goal of Therapy for osteoarthritis
Goal of Therapy
Pain relief and maintain functioning
Goal of Therapy for rheumatoid arthritis
Goal of Therapy
Minimize joint pain and damage, control systemic involvement, prevent disease progression and avoid side effects of medications.
Treatment approaches for osteoarthritis
Treatment approaches
NSAIDS, yoga, muscle stretching, lidocaine patch.
Treatment approaches for rheumatoid
Treatment approaches
Acetaminophen, NSAIDS, PPI, prednisone, anti-rheumatic drugs, biologic response modifiers, PT/OT.
Morbidity for osteoarthritis
Morbidity
Secondary diagnoses are bigger issue, as well as immobility!
Morbidity for rheumatoid arthritis
Morbidity
If not treated, severe disability can occur within 10 years of diagnosis.
What is Sjogren’ syndrome
Sjogren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The condition may affect other parts of the body, including the kidneys and lungs.
Who gets Sjögren’s syndrome
Most people with Sjögren’s syndrome are women. It can occur at any age and in any race. But it is rare in children and most often shows up after age 40.
What causes Sjögren’s
It is an autoimmune disorder.
In Sjögren’s syndrome, your immune system attacks the glands that make tears and saliva (spit). The damage keeps these glands from working right and causes dry eyes and dry mouth.
Dx of Sjögren’s using criteria
Need 4 (study guide said 3) of the following ….AECG CRITERIA
American-European Consensus Group (AECG) classification criteria for definitive diagnosis of Sjogren syndrome
applies to patients with signs or symptoms of Sjogren syndrome
case definition requires ≥ 4 of the following 6 criteria in patients with positive results for histology or serology
ocular symptoms (≥ 1 of the following)
chronic, daily, troublesome dry eyes > 3 months
recurrent sensation of gravel or sand in eyes
use of tear substitutes > 3 times daily
oral symptoms (≥ 1 of the following)
daily sensation of dry mouth > 3 months
recurrent or persistently swollen salivary glands in adulthood
frequent ingestion of liquids to assist in swallowing dry food
ocular signs (positive results on ≥ 1 of the following tests) Schirmer test for tear function performed without anesthesia (positive result ≤ 5 mm of tears in 5 minutes) Rose Bengal or other ocular dye score (positive result ≥ 4 on van Bijsterveld scoring system) positive biopsy of salivary gland (histopathology)
evidence of salivary gland involvement (positive results on ≥ 1 of the following)
unstimulated whole salivary flow collection (< 1.5 mL in 15 minutes)
parotid sialography with evidence of diffuse sialectasia
salivary scintigraphy with delayed uptake, reduced concentration, and delayed excretion of tracer
antibodies to anti-SS-A and anti-SS-B antigens on serology
What is sicca
Sjögren’s syndrome
