Final: Arthritic Hand Flashcards
2 common types of arthritis
Osteoarthritis
Rheumatoid
OA affects which joints
Hip, Knees, spine
Hand: cmc of thumb
symptoms of OA
Crepitus - A grinding, grating feeling or a crunchy sound when joints move
Less ROM
swelling, pain, stiffness
Heberden’s nodes:
at the DIP joints
Bouchard’s nodes:
at the PIP joints
OA treatment
Pain management
Maintain ADLS
Mechanical stresses on hands should be avoided:
pinch, pushing, pulling, repetitive movements
Splinting, AROM, heat
RA
systemic, 75 women
proliferation of synovium of joints
mass of tissue that destroys articular cartilage
Acute stage of RA
Acute- Inflammatory
-Inflammation, pain, swelling, heart/ redness at joint
Treatment at acute
resting hand splints, night
joint protection
Proliferation stage
synovium invades soft tissues
osteoporosis
decrease rom, nodules at joints
Treatment at P stage
RHS at night; day splints as needed
Gentle AROM
Assistive devices and adaptations
Rheumatoid Nodules
subcutaneous nodules are an extra-articular characteristic of RA.
Occur mostly on arms, and elbows
Trigger finger
tendons thicker, and results in cathing/ snapping in extension
Destructive phase of RA
sereve, chronic. Joint deformities ( ulnar drift)
splinting, ROM, assistive devices
Chronic phase of RA
Gross instability of hand joints
Boney fusion of joints
Permanent loss of ROM
Disease may have “burned out”- pain, heat and swelling no longer present
treatment for Chronic phase of RA
assistive devices and adaptations to maintain ADLs
4 types of meds:
NSAIDS, steriods, DMARDS, analgesics
Swan Neck deformity
hyperextension of PIP and flexion of dip.
Boutonniere deformity
flexion of DIP and hyperextension
- Cause is rupture of central slip
mallet finger
droop of DIP. damage to insertion of extensor tendon
general treatment principles
gentle ROM stretching intrinsics heat and cold joint protection pain management
