day nineteen: arthritis Flashcards
osteoarthritis is also known as
degenerative arthritis
osteoarthritis def:
defective integrity of the articular cartilage and changes in the underlying bone
lupus def:
autoimmune disease causing inflammation and blood vessel abnormalities
gout def:
disorder caused by uric acid or urate crystal deposition that usually affect onto a few joint of a time
bursitis def:
inflammation of the bursa
fibromyalgia def:
diffuse widespread pain with specific tender points (is still an autoimmune disease)
inflammation can led to what formation:
osteophyte
osteophye is
a small bone spurs that can cause stiffness and problems with the normal mechanics of movements
what problems can osteophytes cause?
stiffness
problems with normal mechanics
oseteophytes at the MP level can cause
trigger finger
hebebden’s nodes:
distal phalanx osetohyte
bouchard’s nodes:
proximal phalanx osteophyte
crepitus nickname
SNAP CRACKLE POP! rice krispies!!
crepitus definition:
grating popping crackling of tissues and joint surfaces
crepitus is a sign of inflammation and in the case of a joint could indicate uneven joint surfaces and deterioration of cartilage
what could crepitus indicate?
uneven joint surfaces
deterioration of cartilage
crepitus is a sign of
inflammation
name like four risk factors:
excess weight
family history
age / previous injury
work history
is there a cure for OA?
no.
name like two medications for OA:
NSAIDS: naproxen, ibuprofen
compounded cream (topical cream)
Cox 2 inhibitors
chonodroitin
indicators of OA:
pain when pinching / gripping
difficulty performing ADLs especially fasteners, opening jars, and containers
difficulty tearing packages
eval for OA:
CMC grind test
observe these things:
modeling zig zag deformity
tight webspace
ROM
grip and pinch strength
key things to look for in hand deformity in OA (ROM of the bones)
thumb flexion / hyperextension of the IP, joint laxity or hyperextension at the MP
tight webspace indicates
adductor pollicis tightness
ROM of the thumb should be measured especially ____ and _____
palmer and radial ABduction
evaluation:
- assess thumb posture when pinching
2. assess dorsal capsule stability using lateral key pinch
what would three things OT would do with OA:
- educate in web space stretch
- splinting to support CMC
- selective strengthening of stabilizing muscles
in order to perform isometric strengthening of the flexors you would
air ball squeeze for 10 repetitions
rubber band extension
what is the goal of isometric strengthening of the 1 interossei
maintain the natural arch of the thumb which reduces forces at the CMCJ
if you create a splint you want the MP
ONLY
MP only and placed at 30 degrees
post operative rehab things to do:
cast for 4 to 6 weeks
AROM
scar massage
edema control
RA is a
autoimmune disorder
what happens in RA:
the immune system attack the body
destroys soft tissue and ligaments
RA results in
pain and deformity
RA nodeules are
lumps of tissue under the skin
name like three s/s of RA that isn’t joint stiffness:
fatigue / muscle pain
flu like symptoms
loss of appetite / weight loss
pannus
the synovium thickens from 2 cell layers to 12 layers and turn into a tissue called destructive tissue
what stage does pannus occur?
stage 2
describe stage 1
most painful
swelling and inflammation that is warm to touch
early dx and tx focusing on decreasing inflammation in stage 1 = less damage in later stage
what treatment do you want to focus on in stage 1
decrease of inflammation
what is the most painful stage?
1
when do s/s start to decrease?
stage 2
are there obvious deformities in stage 2?
no
pannus eventually leads to
bone erosion
stage 3 is defined as
destructive chronic active phase
- pain is less but irreversible joint damage has occurred
- radiographic changes of bones and cartilage destruction joint deformity and possible tendon rupture
when are s/s irreversible / dx done
stage 3
what happens in stage 4?
skeletal collapse and sever joint deformity
supporting soft tissue are totally deteriorate and the joints become unstable
when is soft tissue totally deteriorated
stage 4
zig zag deformity is secondary to
lack of ligament support
name three splints we would use with RA:
ulnar drift
resting hand splint
wrist support
three adaptations for joint protection
built up handles
use larger joints
adaptive equipment
