Dz: RA & Related Conditions

Question 1

RA (Prognosis, S/S & Etiology)

Answer 1

Systemic inflammatory dz (affects bilateral/symmetrical)
Affects 3:1 females to males
S/S: swollen/hot jnts (excess synovial fluid)
- Pannus: cause degredation of cart/bone
- (3>) Jnts of the foot/hand
>hip/knee/SHO/Elbow
- Pain in am: 2hrs
- Pos RF
Progn: must meet 4 S/S

Question 2

RA (Deformaties)

Answer 2

Trigger Finger
Boutonnieres: hyperext (DIP), flex (PIP), hyperext (MCP)
Swan Neck: flex (DIP), hyperext (PIP)
Ulnar Drift: disrupt lig of MCP jnts
Distal Ralial-Ulnar jt damage: affects pron/sup
Carpel Tunnel Syndrome: pressure on med n
Knees: Genu valgus (“knocked knees”)
C-Spine: atlantoaxial jnt damage, sublux = (quadra/tetraplegia)

Question 3

RA (Non-jnt pathological changes)

Answer 3

Skin Nodules: severe (tendon necrosis)
Sjogrens Syndrome: drye eyes, photophobia
Lung Problems: Resp Infx, lung nodules
Raynaud's: hands = white/blue when cold
Amyloidosis: protein crystals deposited

Question 4

RA ( PT intervention)

Answer 4

passive stretching, hydrotherapy, e-stem at low settings

Question 5

Juvenile RA

Answer 5

Stills dz: lung/heart damage if manifestations

75% remission by adolescents

Question 6

Polymyalgia Rheumatica

Answer 6

Formation of giant cell arteritis
Exasperate pain during late at night/early morning
MI: steroids

Question 7

Fibromyalgia

Answer 7

Numerous tender points (11 of 18)
Increase in substance P
MI: meds to eliminate other causes (depression/anxiety)

Question 8

Ankylosing spondylitis

Answer 8

Can be systemic to internal organs

primarily affects the spine causing fusions to occur (Bamboo spine) and SHO, hips, knees, and SI joint

Question 9

Psoriatic arthritis

Answer 9

Can be systemic to internal organs
primarily affects the jnts in the hands/feet
Causes fingernail pitting and DIP deformities

Question 10

Scleroderma

Answer 10

skin may show loss of elasticity, tightness in the hands (Raynaud’s - discoloration), feet, and face
S/S: lung complications, TMJ, dry eyes or mouth (sjorgrens syndrome)

Question 11

Systemic Lupus

Answer 11

Very common - effects internal organs
S/S: Malar Rash (butterfly)
Can lead to death if NS is involved

Question 12

Myofascial Pain Syndrome

Answer 12

S/S: trigger points localized to 1 or > (referred)
Progn: dry needling
PT: detect with palpation and use acupuncture

Question 13

Complex Regional Pain Syndrome

Answer 13

AKA RSD
Disturbed vasomotor control of UE/LE
More common in Women
Alters pain signal due altered ANS
S/S: excess hair growth, skin changes
PT: desensitization, contrast baths

Question 14

Sjorgen’s Syndrome

Answer 14

Can be primary or associated with other dz (Autoimmune/Connective tissue)
S/S: dry eyes/mouth (inflammation of salivary glands/lacrimal glands), dental/gum problems

Question 15

Myasthenia Gravis

Answer 15

Synapse at neuromuscular jct is destroyed
S/S: eye droop, double vision, speech/swallowing problems
Muscle weakness in face/eyes
Tx: Anticholinesterase Agents (incr Acetyl = nerve action), glucocorticoids