Arthritis/OI Flashcards
Arthritis
inflammation of a joint(s)
Rheumatoid Arthritis (RA)
Systemic, symmetrical, and affects many joints
1. Common in small joints of hands
2. Remmissions/exacerbation occurs
3. Begins in acute phase as an inflammatory process of the synovial lining
4. Contraindication: using hot/cold packs d/t RA pt.s often have unstable vascular reactions to heat and cold that causes greater than normal heat retenion or increeased coldness and stiffness with cold exposure; strenghtening and resistive exercises should be utilized with caution as this may increase inflammation in the joints, increase pain, and ultimately reduce hand function.
(Hand stregnth may not iprove to normal limits 2ndary to pain, stiffness, and limited ROM.)
infection/autoimmune
swollen infoammed synovial membrane; bone erosion
Symptoms of
RA
- pain
- stiffness
- limited ROM
**4. fatigue - weight loss
- limited ADLs, diminished roles
- swelling
- deformities**
Ulnar deviation and
Subluxation of the
wrists and MCP joints
Deformity common with RA
Boutonniere deformity
splint, ex
- disruption of the central slip of the extensor tendon
- flexion of PIP joint; hyperextension of DIP joint
- Splint: PIP in extension; SILVER RINGS
- Exercise: isolated DIP flexion exercises
Deformity common with RA
Swan neck deformity
splint
- injury to the MCP, PIP, or DIP joints
2. PIP hyperextension; DIP flexion - Splint: PIP slight flexion; SILVER RING, BUTTONHOLE/HYPEREXTENSION BLOCK SPLINT, OR DIGITAL DORSAL SPLINT IN SLIGHT PIP FLEXION
Deformity common with RA
Osteoarthritis (OA)
Degenerative joint disease
1. not systemic, but wear & tear
2. commonly affects WB joints
3. attacks hyaline cartilage
Etiology:
1. genetic, trauma, inflammation, cumulative trauma, endocrine and metabolic diseases
bone on bone; thin cartilage
Symptoms of OA
Symptoms:
1. pain
2. stiffness
3. limited ROM
4. bone spurs
nodes at DIP/PIP
What should be avoided when assessing strength and ROM?
- PROM should be avoided, especially in the inflammatory stage. The focus should be on AROM.
- Muscle strength testing should be avoided unless requested by a physician. Instead, document strength in relation to function.
Bulb dynamometer
An inexpensive tool that reliably measures hand and finger strength.
To evaluate for RA
What should be noted if ADLs and role activity deficit is presented?
When documenting ADLs and role activity deficits, it is important to note if the deficits are related to pain, limited in motion, deformity, weakness, or fatigue.
Splint used during the acute stage of RA
- Resting hand splint
- Wrist splint (only if arthritis specific to wrist)
image: resting hand splint
Splint for ulnar deviation deformities
Ulnar drift splint
Dynamic MCP extension splint with radial pull is used for_____.
post-op MCP arthroplasties
hand base thumb split in used for _____.
CMC arthritis
