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PHTY2101 EOS > B3 L41/42: Rheumatology > Flashcards

B3 L41/42: Rheumatology Flashcards

1
Q

Many types of arthritis. What are 4 factors that diagnosis dependent on?

A
  • History of symptoms
    • Signs present
    • Investigations
    • Inflammatory joints with or without associated features should trigger your referral
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2
Q

What is rheumatoid arthritis?

A

Chronic systemic, destructive, inflammatory arthropathy of unknown aetiology

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3
Q

What is the cause of RA?

A

unknown aetiology

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4
Q

What is the prevalence of RA?

A

1-2%

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5
Q

Are males or females more affected by RA? What is the ratio?

A

Females (3:1)

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6
Q

What are the 2 peak onsets for RA?

A

Peak onset 55 years
○ Late childbearing years. Post partum - high risk of RA.
○ Second peak : 60-80 yo

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7
Q

Is RA disabling? What is the ratio of people who stop work 5 years after diagnosis?

A

Yes –> 20%

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8
Q

How many years does RA reduce life expectancy by?

A

7-10 years

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9
Q

What are the 3 Pathogenesis of RA?

A

• Family predisposition
○ First degree relative with RA (RR 1.5)
○ Monozygotic twins 12-15% concordance
• Genetics
○ RA strongly linked to MHC Class II antigens
○ HLA DRB10404
○ HLA DRB10401
• Environment
○ Smoking associated, anti-oxidants/pregnancy/alcohol is protective because dampening immune system?
○ Other triggers? Infections, microbiota, silica dust

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10
Q

What are 7 criteria in the diagnosis of RA-

American College of Rheumatology (ACR) Criteria 1986 (old classification criteria)?

A
  • Morning stiffness > 1hr
    • Three or more joints
    • Smaller hand or feet joints
    • Symmetrical distribution
    • Positive Rheumatoid factor (and/or Anti CCP)
    • Rheumatoid nodules
    • X-ray changes (plus MRI, CT, US)

4/7 criteria and >6 weeks duration

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11
Q

What are 7 criteria in the diagnosis of RA- 2010 ACR/EULAR Classification Criteria for RA (current classification criteria)

A
  • Score >6 = definite RA
    • Better sensitivity & specificity for all stages of RA
    • 1 or more joint definite synovitis (not explained by another disease)
    • Joints small or large
    • RF and anti-ccp (ACPA)
    • CRP and ESR - markers of inflammation in blood
    • Duration of symptoms - minumum 6/52 for diagnosis
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12
Q

What are 16 Clinical Features of RA?

A
  • Pain and swelling on the affected joints
    • Local tenderness to palpation and with ROM
    • Classical “boggy” feeling to the joint (hard plasticine feeling?)
    • Heat and redness of joint
    • Thickening of tendons – tenosynovitis
    • Nodules on tendons – triggering/rupture
    • Reduced grip strength - RA specific symptom
    • Ulnar deviation of fingers
    • Boutonnière and Swan neck deformities in late RA
    • Radial drift of carpals
    • Prominence of ulnar styloid
    • Fixed flexion at elbow - not specific to RA
    • Frozen shoulder
    • Retrocalcaneal bursitis - tarsal tunnel syndrome
    • Knee effusions
    • Baker’s cysts
    • Hip and CV spine in established RA only
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13
Q

What are 5 Typical/Classical Clinical Features of RA?

A
  • Polyarticular disease
    • Gradual onset - weeks to months
    • Predominant symptoms being pain, stiffness and swelling of many joints
    • Morning stiffness (= inflammation) very common, slowness to move.
    • 1/3 have systemic features including myalgia, fatigue, low grade fever, fatigue, weight loss and low mood
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14
Q

What are 3 Palindromic Onset

Clinical Features of RA?

A
  • Episodic symptoms with several joints being affected for hours to days
    • Symptom free periods may last days to months
    • Hard to diagnose - patient might think it’s due to other injury? Need to take a proper history.
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15
Q

What are 4 Monoarthritis (rare)

Clinical Features of RA?

A
  • Persistent single joint arthritis
    • Frequently large joints; knee, shoulder, hip, wrist (in old women)
    • Sole manifestation or herald the onset of polyarticular disease
    • Often a history of trauma/initiating event
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16
Q

What are 6 Extra-articular manifestations of RA?

A
  • Cardiovascular: Pericarditis, myocarditis - death.
    • Respiratory: Pleuritis, intrapulmonary nodules, rheumatoid pneumoconiosis, diffuse interstitial fibrosis
    • Neurological: Peripheral sensory neuropathy, Entrapment neuropathies, Cervical myelopathy
    • Ocular: Episcleritis/scleritis and sicca symptoms
    • Skin: Subcutaneous nodules. Vasculitis.
    • Haematological: Anaemia, Splenomegaly, Felty’s syndrome
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17
Q

What is a respiratory extra-articular manifestations of RA?

A

Pleuritis, intrapulmonary nodules, rheumatoid pneumoconiosis, diffuse interstitial fibrosis

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18
Q

What is a neurological extra-articular manifestations of RA?

A

Peripheral sensory neuropathy, Entrapment neuropathies, Cervical myelopathy

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19
Q

What is an ocular extra-articular manifestations of RA?

A

Episcleritis/scleritis and sicca symptoms

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20
Q

What is a skin extra-articular manifestations of RA?

A

Subcutaneous nodules. Vasculitis.

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21
Q

What is a haematological extra-articular manifestations of RA?

A

Anaemia, Splenomegaly, Felty’s syndrome

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22
Q

What is a cardiovascular extra-articular manifestations of RA?

A

Pericarditis, myocarditis - death.

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23
Q

What are 3 things found in a blood test of RA?

A
  • FBC, e/LFTs, ESR/CRP
    • Rheumatoid factor (non-specific for RA)
    • Anti-CCP antibodies (98% specific for RA)
    • We test both RA factor and anti-CCP. If both present, then worse prognosis.
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24
Q

What are 3 things found in imaging of RA?

A

• X-rays: RA affects wrist & MCP, maybe PIP, never DIP. Erosion at joints, dislocation/subluxation, loss of joint space
○ Baseline hands and feet, other joints if indicated.
○ CXR.
• MRI: Early synovitis, early erosion (can’t see on X-ray), bone marrow oedema, tenosynovitis.
• Ultrasound: Rotator cuff/tendinopathy

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25
Q

What are the 5 Prognosis features of RA?

A

• Variable clinical course
• Disease fluctuation, flares, remission
• Poor prognostic markers
○ High initial disease activity
○ Poor functional capacity at diagnosis
○ High inflammatory markers ESR/CRP
○ Antibodies RF and anti-CCP (seropositive disease)
○ Erosions at baseline x-rays
• Increased risk for CVS disease, infections & lymphoma
• Reduced life expectancy and quality of life

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26
Q

What are 3 SPONDYLOARTHROPATHY (SpA) rheumatic conditions? 3 others?

A
  • Ankylosing spondylitis
    • Psoriatic arthritis
    • Reactive arthritis
    • Arthropathy of inflammatory bowel disease
    • Undifferentiated spondyloarthropathy
    Juvenile onset spondyloarthropathy
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27
Q

Is SpA common?

A

Yes –> 1-3%

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28
Q

SpA can affect people of ny age but primarily __________.

A

young adults

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29
Q

What is a respiratory extra-articular manifestations of RA?

A

Pleuritis, intrapulmonary nodules, rheumatoid pneumoconiosis, diffuse interstitial fibrosis

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30
Q

What is a neurological extra-articular manifestations of RA?

A

Peripheral sensory neuropathy, Entrapment neuropathies, Cervical myelopathy

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31
Q

What is an ocular extra-articular manifestations of RA?

A

Episcleritis/scleritis and sicca symptoms

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32
Q

What is a skin extra-articular manifestations of RA?

A

Subcutaneous nodules. Vasculitis.

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33
Q

What is a haematological extra-articular manifestations of RA?

A

Anaemia, Splenomegaly, Felty’s syndrome

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34
Q

What is a cardiovascular extra-articular manifestations of RA?

A

Pericarditis, myocarditis - death.

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35
Q

What are 3 things found in a blood test of RA?

A
  • FBC, e/LFTs, ESR/CRP
    • Rheumatoid factor (non-specific for RA)
    • Anti-CCP antibodies (98% specific for RA)
    • We test both RA factor and anti-CCP. If both present, then worse prognosis.
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36
Q

What are 3 things found in imaging of RA?

A

• X-rays: RA affects wrist & MCP, maybe PIP, never DIP. Erosion at joints, dislocation/subluxation, loss of joint space
○ Baseline hands and feet, other joints if indicated.
○ CXR.
• MRI: Early synovitis, early erosion (can’t see on X-ray), bone marrow oedema, tenosynovitis.
• Ultrasound: Rotator cuff/tendinopathy

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37
Q

What are the 5 Prognosis features of RA?

A

• Variable clinical course
• Disease fluctuation, flares, remission
• Poor prognostic markers
○ High initial disease activity
○ Poor functional capacity at diagnosis
○ High inflammatory markers ESR/CRP
○ Antibodies RF and anti-CCP (seropositive disease)
○ Erosions at baseline x-rays
• Increased risk for CVS disease, infections & lymphoma
• Reduced life expectancy and quality of life

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38
Q

What is the prevalence of Psoriatic Arthritis before arthritis?

A

2/3

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39
Q

Is SpA common? What is the prevalence/

A

Yes –> 1-3%

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40
Q

SpA can affect people of ny age but primarily __________>

A

young adults

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41
Q

What is SpA?

A

Progressive chronic conditions with long term complications, musculoskeletal and extra-articular

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42
Q

Prognosis depends on the _______ and _____ of SpA.

A

form; severity

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43
Q

Treatment options for SpA have improved but remain _______.

A

suboptimal

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44
Q

What are 9 Clinical Features of SpA?

A 
• Inflammatory back pain
	• Sacroiliitis
	• Absence of rheumatoid factor (no ACCP)
	• Associated HLA-B27+
	• Asymmetrical peripheral arthritis
	• Dactilitis/enthesitis - sausage digits, synovitis of multiple joints & tendons.
	• Skin psoriasis
	• Eye inflammation (uveitis)
Gastrointestinal/genitourinary symptoms
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45
Q

What is the prevalence of Ankylosing Spondylitis?

A

0.5%

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46
Q

_____ (males/females) at ___ yrs old are most affected by Ankylosing Spondylitis?

A

Males; 40 yrs

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47
Q

Spondylitis affects the _______ and begins in _______joints

A

spine; sacroiliac

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48
Q

What are 5 Clinical Features of AS?

A
  • Lose lumbar lordosis
    • Thoracic kyphosis
    • Fixation due to ossification
    • Cervical fixed
    • Hip immobile
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49
Q

What are 8 features of inflammatory back pain?

A

• Worse with rest and inactivity. Different to mechanical pain which gets worse with activity.
○ Differentiation from mechanical back pain is critical.
• Morning stiffness improves during the day
• Nocturnal pain
• Responds to NSAIDs
• Onset before age 30 – mostly back to late teenage years

• Also affects chest wall and inflammatory peripheral arthritis
	○ Enthesitis, dactylitis, large joint monoarthritis
	○ Achilles tendinitis, plantar facsciitis, gluteal tendinitis, sausage digits
• Extra-articular manifestations e.g. uveitis, lung fibrosis, aortitis
• Associated diseases common e.g. IBD and psoriasis
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50
Q

What is the prevalence of Psoriatic Arthritis after arthritis?

A

1/3

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51
Q

What are 10 features of Psoriatic Arthritis?

A
  • Pain and stiffness in affected peripheral joints
    • Polyarticular and monoarticular
    • Several patterns of joint involvement, very heterogeneous disease
    • Axial involvement
    • AS like disease – HLAB27+
    • SI joints 10%
    • 15-30% of psoriasis complicated by psoriatic arthritis
    • Joint pain, decreased mobility and QoL, increased CVS disease
    • Psoriasis and inflammatory arthritis ++ debilitating
    • Therapy improving - remains unsatisfactory
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52
Q

What is Psoriatic Arthritis? List 6 characteristics?

A
  • Autoimmune disease
    • Common inflammatory skin disease 1-3% population
    • Plaques of thick scaly skin
    • Decreased transit time of a keratinocyte
    • Activated immune cells in dermis
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53
Q

What is the cause of Reactive Arthritis?

A

1-6 weeks post infective illness
• Infection either enteric or urogenital
○ Salmonella, campylobacter, Chlamydia, streptococcal
○ 80% reactive arthritis are chlamydia related

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54
Q

Reactive Arthritis affects ___ (males/females) at ____ years old.

A

male; 2-40yrs old

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55
Q

What are 3 features of reactive arthritis?

A

• Most often monoarthritis, large joints and enthesitis is common
• Self-limiting, reoccurring and chronic arthritis
○ Rule of thirs: 1/3 of time do nothing and it will go away. 1/3 time it will recur. 1/3 time it will stay.
• Initial manifestation of other SpA

56
Q

What are 4 features of Overlap CTD syndromes?

A
  • Combines features of RA, SLE, Scleroderma, Polymyositis and other CTDs
    • Skin changes, arthritis, myalgia, pleurisy, renal, pulmonary involvement and MORE
    • Auto antibodies assist in diagnosis
    • Small number of patients and diverse diseases therefore treatment is individual
57
Q

What does Inflammatory Bowel Disease (IBD) Associated Arthritis affect?

A

Inflammatory peripheral arthritis and sacroilitis/ spondylitis

58
Q

Management of Inflammatory Bowel Disease (IBD) Associated Arthritis is different to bowel disease however treatments may __________.

A

overlap

59
Q

Interestingly up to 2/3 of patients with SpA have subclinical inflammatory lesions of the __________.

A

bowel

60
Q

What is Undifferentiated Spondyloarthropathy?

A

Patients who do not meet established criteria for other SpA

61
Q

What are the 2 subtypes of Undifferentiated Spondyloarthropathy?

A

○ Axial

○ Peripheral

62
Q

_______ is associated with Undifferentiated Spondyloarthropathy.

A

HLA-B27+

63
Q

What are the 3 features of Undifferentiated Spondyloarthropathy?

A
  • May have features of all SpA and associated diseases
    • May develop into another recognised form of SpA
    • Non-radiographic SpA (AS-like disease pre changes on plain films with or without MRI changes)
64
Q

What are Connective Tissue Diseases (CTD)?

A

Group of diseases mediated by an immune response to an auto-antigen

65
Q

__________ are diagnosed on grounds of specific clinical and laboratory findings

A

Connective Tissue Diseases (CTD)

66
Q

Connective Tissue Diseases (CTD) share many clinical features but are very diverse in presentation, course and ____________.

A

prognosis

• Commonly an inflammatory arthropathy is present
67
Q

What is the prevalence of Systemic Lupus Erythematosus (SLE)?

A

20-50/100000

68
Q

What are 3 features of limited scleroderma?

A 
• Cutaneous manifestations that mainly affect the hands, arms and face
	• Previously called CREST syndrome
		○ Calcinosis
		○ Raynaud’s phenomenon
		○ Oesophageal dysfunction
		○ Sclerodactyly
		○ Telangiectasia
	• Pulmonary arterial hypertension may occur in up to 1/3
69
Q

What does Systemic Lupus Erythematosus (SLE) affect?

A

Affects multiple organs through antibody-immune complex formation

70
Q

What are 2 concerning symptoms of Systemic Lupus Erythematosus (SLE)?

A

butterfly rash

kidney symptoms

71
Q

Systemic Lupus Erythematosus (SLE) flares with periods of _____. This is _____ (common/uncommon).

A

remission; common

72
Q

What is treatment of Systemic Lupus Erythematosus (SLE) determined by?

A

Treatment determined by nature and severity of organ involvement

73
Q

What is Scleroderma?

A

Systemic Sclerosis

74
Q

Is Scleroderma common?

A

No (1/100000)

75
Q

Scleroderma’s severity _____ considerably.

A

varies

76
Q

What is Scleroderma characterised by?

A

fibrosis or hardening of the skin, vascular alterations and auto antibodies
○ Joints are fixed by the fibrosis of skin. Could get arthritis under scleroderma.

77
Q

What are the 2 major forms of scleroderma?

A

Limited

Diffused

78
Q

What are the 3 acute presentation of Gout?

A

joint pain, swelling, redness

79
Q

What are 2 features of Viral - Post Infectious Arthritis?

A

• Arthralgia is usually self-limited, symmetrical and in peripheral small joints
Non-specific joint & muscle pain, maybe signs of arthritis - maybe viral.

80
Q

What are 9 infectious agents which cause Viral - Post Infectious Arthritis?

A 
○ Parvovirus
		○ Hepatitis A,B,C
		○ Rubella
		○ HIV
		○ EBV
		○ CMV
		○ Varicella Zoster
		○ Ross River, West Nile
		○ Dengue…
81
Q

How prevalent is Crystal Arthropathy (Gout)?

A

5-8%

82
Q

Crystal Arthropathy (Gout) most commonly affects _____ (males/females)between _____ yrs old. There is an increased prevalence is ____ ethnicities.

A

males; 40-60; south Polynesians

83
Q

Crystal Arthropathy (Gout) is associated with ______syndrome

A

metabolic

84
Q

What are 3 features of Crystal Arthropathy (Gout)?

A
  • Acute, palindromic or chronic tophaceous
    • Classically first MTP joint
    • Other joints – ankles/knees/wrists/polyarticular
85
Q

What is Gout?

A

High uric acid in blood, crystals precipitated in joints - inflammation, real painful. most common place of gout is 1st MTP. Comes on within hours.

86
Q

What is Pseudogout?

A

Calcium Pyrophosphate crystals with chronic OA

87
Q

What are the 3 acute presentation of Gout?

A

joint pain, swelling, redness

88
Q

________ of joint for detection of crystals (diagnosis) and to rule out infection is the gold standard

EXAM QUESTION

A

Aspiration

89
Q

Why is fast detection key for Gout?

A

Infection can destroy joint in 24 hours.

90
Q

___________ is associated with low grade arthritis

A

Inflammatory Myopathy

91
Q

What is Systemic Vasculitis?

A

Inflammation of the blood vessels

92
Q

Systemic Vasculitis leads to end organ damage through _____ and _____ due to vessel occlusion

A

infarction; haemorrhage

93
Q

Systemic Vasculitis varies from limited cutaneous to _____ life and organ threatening

A

catastrophic

94
Q

Systemic Vasculitis is characterised by the ________ of the _____ involved

A

size; vessels

95
Q

What is systemic vasculitis caused by?

A

Inflammatory arthritis at any stage associated to the systemic illness

96
Q

What are 4 features of septic arthritis?

A

• Monoarticular (80%) presentation
• Knee and Hip most common joints
• Painful effusion (1-2 days), erythema, warmth, decreased ROM
CRP/ESR and WCC elevated

97
Q

What are 4 risk factors of septic arthritis?

A

Age, Diabetes, Immunosuppression, Joint surgery

98
Q

What are 3 organisms associated with septic arthritis?

A

Staph/Strep, Gonorrhoea, Gram negatives

99
Q

What are 2 important management techniques for septic arthritis?

A

○ Diagnosis via aspiration!!!

Urgent orthopaedic review and washout and antibiotics

100
Q

What is OA?

A

Disease of complex aetiology that results in loss of normal function of a joint due to breakdown of articular cartilage

101
Q

What are 5 factors that affect OA?

A 
○ Joint integrity
		○ Genetics
		○ Local inflammation
		○ Mechanical forces
Cellular and biochemical processes
102
Q

_______is the most commonly diagnosed musculoskeletal condition

A

OA

103
Q

OA symptoms are uncommon before ____ and significantly ____ (increase/decrease) with age

A

40; increase

104
Q

> _____% of >_____ yrs have OA symptoms.

A

50; 65

105
Q

What are the 2 features of OA?

A 
• Focal areas of cartilage loss in joints
	• Accompanied by joint remodelling
		○ Subchondral bone changes
		○ Osteophyte formation
Joint capsule thickening
106
Q

• Articular cartilage failure
• Interactive degradation and repair processes of cartilage, bone and synovium
• Chondrocytes probably most important cell involved
○ Abnormal metabolism: Increased synthesis, proliferation and activity

Initiation of OA involves abnormalities in the biomechanical forces and/or the cartilage.
Once begun the pathway leading to OA involves many other factors
• Mechanotransduction
• Proteases, protease inhibitors and cytokines affecting cartilage degradation and repair
• Contribution from multiple risk factors

A

ADDDD

107
Q

What are 9 Risk Factors of OA?

A
  • Age and gender F>M
    • Obesity
    • Genetics
    • Musculoskeletal injury
    • Joint Instability/laxity/muscle weakness
    • Abnormal joint shape/malalignment
    • Repetitive physical stress (occupational)
    • Hormonal influences - women?
    • Other joint or bone processes
108
Q

What are the 2 ways that OA is divided by?

A

Idiopathic Osteoarthritis

Secondary Osteoarthritis

109
Q

What are 2 features of Idiopathic Osteoarthritis?

A

○ Localised

Generalised (≥3 joint sites)

110
Q

What are 5 features of Secondary Osteoarthritis?

A

○ Result of a specific condition or event
○ Trauma
○ Congenital or developmental disorders
○ Joint or bone diseases e.g. Osteonecrosis, Rheumatoid arthritis, Gout, Septic arthritis, Paget’s disease, CPPD
○ Other diseases e.g. Diabetes, Acromegaly, Hypothyroidism, Neuropathy, Haemachromatosis, Wilson’s disease

111
Q

What are the 2 signs of OA in the hand?

A

• Heberden’s (DIPs) and Bouchard’s nodes (PIPs)

1st CMC joint – ‘squaring of hands’

112
Q

What are 6 diagnostic features of knee OA?

A 
Knee pain + ≥3/6 features
	1. >50 yo
	2. Am stiffness <30minutes
	3. Crepitus on active motion of the knee
	4. Bony tenderness
	5. Bony enlargement
No palpable warmth
113
Q

What are 4 diagnostic features of hand OA?

A

Hand pain + ≥3/4 features
1. Hand tissue enlargement of 2 or more joints of 10 selected joints
○ Selected joints: 2nd & 3rd DIPJs, 2nd & 3rd PIPJs and 1st CMC both hands. Never MCP.
2. Hand tissue enlargement of 2 or more DIPJs
3. <3 swollen MCPs
4. Deformity of ≥1/10 selected joints

114
Q

What are 3 diagnostic features of hip OA?

A

Hip pain + ≥2/3 features

1. ESR <20mm/h
2. Radiographic osteophytes (X-ray) 3. Joint space narrowing on radiography
115
Q

What is the prognosis for knee OA?

A

Older age strongest risk factor for progression

116
Q

What is the prognosis of hand OA?

A

Higher BMI and polyarticular arthritis predicts x-ray progression

117
Q

What is the prognosis of hip OA?

A

Progression to total hip replacement includes female gender, night pain, lower baseline functional capacity

118
Q

What are the 8 symptoms of OA?

A

• Pain worse with activity & resolves with rest
○ Increased at the end of the day, after activity
• ROM elicits pain
• Crepitus
• <20 minutes morning stiffness
• Gelling phenomenon
• No systemic features
• Consider age
• Remember often OA is concomitant with inflammatory arthritis

119
Q

What are 6 signs of OA?

A
  • Tenderness of involved joint
    • No evidence of inflammation
    • Crepitus
    • Bony enlargement (osteophytes)
    • Decreased ROM
    • Joint malalignment/subluxation/deformity
    • Characteristics of specific joint involvement
120
Q

What is the sign of OA in the feet?

A

• 1st MTP – hallux valgus or rigidis

121
Q

What is the sign of OA in the knees?

A

• Osteophytes, effusions, crepitus, limited ROM, malalignment (genu varum or valgus), Baker’s cysts, patellofemoral discomfort

122
Q

What are the 2 signs of OA in the hips?

A

• Limited ROM

Not usually discreet tenderness

123
Q

What is the sign of OA in the spine ?

A

• Limited ROM

124
Q

What is the sign of OA in the shoulders?

A
  • Limited ROM

* Osteophytes

125
Q

What is the gold standard for OA diagnosis?

A

x ray

126
Q

What are 7 benefits of x ray for OA diagnosis?

A 
○ Joint space narrowing
		○ Subchondral bone sclerosis
		○ Marginal osteophyte formation
		○ Subchondral bone cysts
		○ Insensitive with early disease
		○ Correlates poorly with symptoms
		○ Clinical relevance varies by joint
127
Q

What are 3 benefits of MRI for OA diagnosis?

A

○ Inflammatory symptoms
○ Instability requiring investigation
○ Probs don’t need MRI.

128
Q

When is MRi used over x ray?

A

Diagnostic role when other features are present

129
Q

What are the 3 features of prognosis of OA?

A
  • Variable
    • Slowly progressive
    • Differs by joint
130
Q

Articular cartilage is ______ (a)neural and _____ (a)vascular.

A

aneural; avascular

131
Q

What are 3 Intra-articular sources of pain in OA?

A

Periostial , osteophyte formation

132
Q

What are 5 Periarticular sources of pain in OA?

A

Inflammation of tendon, fascia, bursae, muscle, nerve

133
Q

What are 2 Psychosocial aspects of OA?

A

Lower education levels, depression

134
Q

OA uses ____ and _____ management

A

Pharmacological; non-pharmacological

135
Q

What are the 3 goals of management for OA?

A

○ Reduce pain
○ Improve function
Prevent disabiliy

PHTY2101 EOS (22 decks)

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