CH 1 Arthritic/skeletal/soft tissue conditions Flashcards
DJD/OA is characterized by
degeneration of articular cartilage, with hypertrophy of subchondral bone and joint capsule of weight bearing joints
Medications for OA:
cortiscosteroids, NSAIDS; Glucocorticoids are injected in to joints that are inflamed and not responsive to NSAIDS
Diagnostic tests reveal what for DJD/OA
diminished point space, decreased height of articular cartilage and osteophytes
What is ankylosing Spondylitis
progressive inflammatory disorder of unknown etiology
Ankylosing Spondylitis begins in the
axial skeleton
The initial onset of ankylosing spondylitis is typically in what decade of life
before the fourth decade
First symptoms of ankylosing spondylitis
mid and low back pain, morning stiffness and sacroiliitis
Advanced ankylosing spondylitis is characterized by
degeneration of peripheral and costovertebral joints
ankylosing spondylitis effects ___ 3x more than __
men, women
2 drugs besides NSAIDS/corticosteroids for ankylosing spondylitis
Cytotoxic drugs - block cell growth and Tumor necrosis factor inhibitors
Diagnostic test for ankylosing spondylitis:
HLA-B27
What is Gout
genetic disorder of purine metabolism characterized by elevated serum uric acid
Where is gout most frequently observed
knee and great toe
Specific NSAID for gout
indomethacin
Diagnostic test for gout
lab tests identify monosodium rate crystals in synovial fluid or connective tissue samples
What is psoriatic arthritis
chronic, erosive inflammatory disorder of unknown etiology
2 drugs for psoriatic arthritis
DMARDS - disease modifying anti rheumatic drugs; BRM: biological response modifiers
What is rheumatoid arthritis
chronic systemic disorder involving a symmetrical pattern of dysfunction of synovial tissues of hands, wrists, elbows, shoulder, knees ankles and feet
Most effected joints in RA
MCP and PIP
Characteristic of RA
pannus formation, ulnar drift and volar subluxation of MCP joints; DIPs usually spared; swan neck and boutonniere deformity , Bouchard’s nodes (excessive bone formation on dorsal aspect of PIP)
Juvenile RA onset is prior to age
16
RA meds:
DMARDs, gold compounds, NSAIDS, immunosupresants, corticosteroids
RA lab test results
increased WBCs and erythrocyte sedimentation rate. Hemoglobin/hematocrit shows anemia and RA factor is elevated
what is osteoporosis
a metabolic disease that depletes bone mineral density/mass
what is senile osteoporosis caused by
decrease in bone cell activity secondary to genetics or acquired abnormalities
DDx ankylosing spondylitis and Spinal stenosis in history intake
Ankylosing spondylitis: morning stiffness, sharp pain to an ache, bilateral SI pain referring to posterior thigh. Spinal Stenosis: intermittent aching pain, may have neurogenic intermittent claudication
imaging DDx ankylosing spondylitis and stenosis
AS: plain films, stenosis: CT scan
Osteomalacia is characterized by
decalcification of bones due to Vit D deficiency
Osteomyelitis
an inflammatory response within bone caused by an infection
most common infection cause in osteomyelitis
staphylococcus aureus
Arthrogryposis multiplex congenita
contractures, sausage like limbs
Osteogenesis imperfectA
Autosomal dominant; abnormal collagen synthesis leading to an imbalance between bone deposition and reabsorption.
osteochondritis dissecans
separation of articular cartilage from underlying bone; typically medial femoral condyle
when is surgical care of myositis ossificans warranted
only non hereditary and after maturation of the lesion (6-24 months)
difference between CRPS I and II
both have dysfunction in the sympathetic nervous system but I has no underlying nerve injury and II has a nerve injury
Paget’s disease
abnormal osteoclastic and osteoblastic activity
For less than ___degrees scoliotic curve, PT is indicated
25
spinal orthosis for scoliosis is indicated for _______degrees
25-45 degrees
