Chapter 50 Dosorders Of Musculoskeletal Function Flashcards
Arthritis
. Primary arthritis
- those affecting body systems in addition to the musculoskeletal system
- resulting from an immune response
. Secondary arthritis
- Rheumatoid conditions limited to a single or few diaarthrodial joints
- Resulting from a degenerative process and the resulting of joint
- irregularities that occur as bone attempts to remodel itself
Systemic Autoimmune rheumatic disease
- Rheumatoid arthritis
- systemic lupus erythematosus
. Systemic sclerosis/ scleroderma
. Polymyositis
. Dermatomyositis
Characteristics of rheumatoid arthritis
. Associated with extra- articular as well as articular manifestations
. Usually has an insidious onset marked by systemic manifestations such as fatigue, anorexia, weight loss, and generalization aching and stiffness
. Characterized by exacerbation and remissions
. May involve only a few joints for brief durations, or it may become relentlessly progressive and debilitating
Systemic Autoimmune Rheumatoid disease
. A group of chronic disorders characterized by diffuse inflammatory lesions and degenerative in connective tissue
- These disorders share similar clinical features and may affect many of the same organs
Treatment Goals for a person with RA
. Reduce pain
. Minimize stiffness and swelling
. Maintain mobility
. Become an informed health care consumer
Criteria for rheumatoid arthritis
. Morning stiffness at least 1 hour for at least 6 weeks
. Swelling of three or mor joints for at least 6 weeks
. Swelling of wrist, metacarpophalangeql or proximal interphalangeql joints for 6 or more weeks
. Systemic joint swelling
. Hand roentgenogram changes or typical of RA
. Rheumatoid nodes
. Serum rheumatoid factor
Result of progressive Joint destruction
. May lead to subluxation
. Inability to the joint
. Limitations of movement
Symptoms of RA
. Fatigue
. Weakness
. Anorexia
. Weight loss
. Low grade fever
. Anemia
Characteristics of systemic Lupus erythematosus
. Formation of autoantibodies and immune complex
. B- cell hyperactivity
. Increased production of antibodies against self and non- self antigens
Characteristics of systemic lupus erythematosus
. The autoantibodies can directly damage tissues or combine with corresponding antigens to form tissue damaging immune complexes.
- autoantibodies . Antinuclear antibodies . Other antibodies . Platelets . Coagulation factors . Red blood cell surface antigen
Categories of clinical manifestations of SLE
. Constitutional . Musculoskeletal . Dermatological . Cardiovascular . Pulmonary . Renal . Neuropsychiatric
Systemic sclerosis
. Autoimmune disease of connective tissue characterized by excessive collagen deposition in the skin and internal organs
. Diffuse or generalized form
- skin changes involve the trunk end proximal extremities
. Limited or CREST variant
- Hardening of the skin is limited to the hands and face
Manifestations of the CREST syndrome
. Calcinosis . Raynaud phenomenon . Esophageal dysmobility . Sclerodactyly . Telangiectasia
Types of seronegative spondyloarthopathies
. Inflammation and involvement of the peripheral joints with an absence of RF
. Ankylosing spondylitis
- Juvenile ankylosing spondylitis
. Reactive arthritis, enteropathic arthritis
. Psoriatic arthritis
Methods of assessing Mobility and detecting sacrolitis
. Pressure on the scaroiliac joints with the person who is forward bending
Reuter syndrome
. Clinical manifestations of reactive arthritis
. Accompanied by extra- articular symptoms such as uveitis, bowel inflammation, carditis
. Develops in a genetically susceptible host after a bacterial infection due to chlamydia trachomatitis in the genitourinary tract
. Salmonella, shigella, yersinia, or campylobacter in the gastrointestinal tract
Subgroups of Psoriatic Arthritis
. Oligaarticular or asymmetric (48)
. Spondyloarthropathy (24%)
. Poly articular or symmetric (18%)
. Distal interphalangeal (8%)
. Mutilans ( 2%)
Causes of osteoarthritis
. Post inflammatory disease . Post traumatic disorders . Anatomic or bony disorders . Metabolic disorders . Neuropathic arthritis . Hereditary disorders of collagen . Idiopathic or primary variants
Osteoarthritis
. Degenerative joint disease
. Primary variants of OA occur as localized or generalized syndromes
.
. Secondary OA has a known underlying cause such as
- congenital or acquired defects of joint structures, trauma, metabolic disorders, inflammatory diseases
Osteoarthritis induced joint changes
. Progression - A progressive loss of articular cartilage . Synovitis - Osteophytes . Bone spur
. Manifestations
- joint pain
- stiffness
- limitation of motion
- joint instability
- deformity
Metabolic and endocrine diseases associated with joint symptoms
. Amyloidosis . Gout syndrome . Osteogenesis imperfects . Diabetes melittus . Hyperparathyroidsm - Thyroid disease . AIDS . Hyper mobility syndrome
Gout syndrome
. Acute gouty arthritis with recurrent attacks of severe articular and periaarticular inflammation
. Tophi or the accumulation of crystalline deposits in articular surfaces, bones, soft tissue, and cartilage
. Gouty nepthropathy or renal impairment
. Uric acid kidney stones
Types of gout
. Primary Gout
- designate cases on which the cause of the disorders is unknown or an unborn error metabolism
- characterized primarily by hyperuricemia and gout
. Secondary gout
- the cause of the hyperuricemia is known but the gout is not the main disorder
Objective for treatment of Gout
. Termination and prevention of the acute of gouty arthritis
. Correction of hyperuricemia
. Inhibition of further precipitation of sodium urate
. Absorption of urate crystal deposits already in the tissue
