Collagen and Connective Tissue Disorders

Question 1

What are common collagen and connective tissue disorders?

Answer 1

• arthritis (osteo-, rhumatoid)
• fibromyalgia
• chronic fatigue
• systemic lupus erythematosus (SLE)
• lyme disease
• Paget’s disease
• capsulitis including capsular patterns

Question 2

What is fibromyalgia and what causes it?

Answer 2

• a immune system disorder, unknown origin, causes tenderness, pain, and stiffness in muscles.
• often related to stress, anxiety, fatigue, and sleeplessness in women more than men.
• characterized by aching or burning in muscles, “migraine of the muscle” diffuse pain, tender points on both sides of the body.

Question 3

Differential diagnosis of fibromyalgia?

Answer 3

• widespread pain in at least 11 of 18 tender points throughout body
• recognition of typical pattern of non-rheumatic symptoms and sleep deprivation.
• exclusion of other systemic diseases

Question 4

Treatment of fibromyalgia?

Answer 4

• holistic/multidisciplinary approach is necessary (ADL edu/training, stress management, meds: analgesics/antidepressants, local modalities/techniques for pain relief, aerobic/conditioning)
• improve sleeping patterns

Question 5

What is Gout or gouty arthritis?

Answer 5

• metabolic disease, elevated serum uric acid and deposition of urate crystals in joints, soft tissue and kidneys.
• most often affects feet, especially the big toe, ankle and mid-foot.
• severe joint pain at night with warmth, erythema and extreme tenderness/hypersensativity

Question 6

How is gout treated?

Answer 6

• anti inflammatory meds
• daily use of colchicine
• lowering of urate concentration in body fluids by diet, wt loss, moderation of alchohol.
• allopurinol to reduce hyperuricemia
• rest, elevation, and jt protection during acute phase

Question 7

What is hemophilia and what are PT considerations?

Answer 7

• hereditary hemorrhagic disorder, deficiency of specific clotting factors.
• PT concerns are muscle bleeds (possible pain, swelling, extreme tenderness, peripheral neuropathies, muscle atrophy, ischemia and gangrene), hemiarthrisis

Question 8

How is hemophilia treated?

Answer 8

• ice, rest, and elevation in acute stage
• splinting
• chronic cases joint protection, maintaining jt function, daily Ex for ROM, endurance and strength, ADL training, use of appropriate splints and assistive devices should be addressed.

Question 9

What is osteomalacia and how is it treated?

Answer 9

• decalcification of bones, results from Vit D deficiency, may cause deformities, fractures and severe pain.
  Tx - pain control, functional mobility training