Arthritis Flashcards
Osteoarthritis
most common - Slow progressive non inflammatory joint disease
Where does OA occur?
Common to synovial joints-distruction of cartiledge
Who is affected by OA
Men before 50, women after 50
Causes of OA
No single cause- decreased estrogen, genetic, obesity, inactivity or overuse, acl injury
Clinical Manifestations of OA
seak tx d/t pain
No systemic- joint pain/discomfort.
Early relieved by rest, advanced- pain and activity and rest
Morning stiffness common, resolved w/in 30 min
Crepitation
Deformity
Deformity associated with OA
Heberden- DIPS (distal)
Bouchards- PIPS (proximal)
INTERPHALANGEAL
Also, MCP , knee/hip, MTP (foot) gout, cervical and lower lumbar
DX of OA
Bone scan, CT, x-ray (not always consistant w pain report), synovial fluid analysis, no labs
Acute Interventions for OA
meds,
temp,
relaxation,
splints
Chronic Interventions for OA
environmental mod.
Assistive device,
sex counsel
Rheumatoid Arthritis
systemic autoimmune disease- Inflammation of synovial joints, remission/exacerbation,
Population for RA
all ethnic groups,
any age,
peak at 30 & 50
. Women 2-3x more
Causes of RA
Autoimmune to antigen triggers- IgG
Genetic- development of leukocyte antigen, variations.
Smoking increases risk
Clinical Manifestations of RA
Nonspecific manifestation may precede arthritic complaints
Weight loss, fatigue, anorexia, generalized stiffness
Many clients report hx. of a preceding stressful life event or stressor
No research to correlate directly with onset of RA
Joint Symptoms with RA
Joint symptoms occur symmetrically
Small joints of hand and feet most often affected
PIP, MCP of hands and MTP of feet
Joint stiffness after periods of inactivity, Joint pain increases with activity
Pain/Stiffness with RA
Morning stiffness longer than 60min. To several hours.
Pain does not always correlate with degree of swelling, inflammation
Inflammation and fibrosis may lead to deformity and disability
Atrophy of muscle / Destruction of tendons
DX of RA
H&P *RF- rheumatoid factor (80% of RA pts = positive) *Erythrocyte sedimentation rate *c-reactive protein anti-nuclear antibody Anti ccp Synovial fluid analysis
Synovial fluid analysis for RA
early detection = strawberry fluid w fibrin flecks
tissue biopsy- confirms inflammation
Problems associated with RA
septic arthritis, sjogren syndrome, neuropathy, anemia, leukopenia diabetes, CA
GOUT
sodium urate crystals in joints, subcu tissue
Primary Gout
90%
Hereditary, middle age men rare in women
Secondary Gout
related to 2nd disorder
Risk factors of Gout
obesity, HTN, thiazides, etoh, purine rich foods
Acute Gout
more than one joint,
dusky,
tenderness (big toe)
often precipitated by another event (trauma, EtOH, infection)
Onset of Acute Gout
rapid, at night,
low fever,
subside in 2-10 days
