Final: Arthritic Hand

Question 1

2 common types of arthritis

Answer 1

Osteoarthritis

Rheumatoid

Question 2

OA affects which joints

Answer 2

Hip, Knees, spine

Hand: cmc of thumb

Question 3

symptoms of OA

Answer 3

Crepitus - A grinding, grating feeling or a crunchy sound when joints move
Less ROM
swelling, pain, stiffness

Question 4

Heberden’s nodes:

Answer 4

at the DIP joints

Question 5

Bouchard’s nodes:

Answer 5

at the PIP joints

Question 6

OA treatment

Answer 6

Pain management
Maintain ADLS
Mechanical stresses on hands should be avoided:
pinch, pushing, pulling, repetitive movements
Splinting, AROM, heat

Question 7

RA

Answer 7

systemic, 75 women
proliferation of synovium of joints
mass of tissue that destroys articular cartilage

Question 8

Acute stage of RA

Answer 8

Acute- Inflammatory

-Inflammation, pain, swelling, heart/ redness at joint

Question 9

Treatment at acute

Answer 9

resting hand splints, night

joint protection

Question 10

Proliferation stage

Answer 10

synovium invades soft tissues
osteoporosis
decrease rom, nodules at joints

Question 11

Treatment at P stage

Answer 11

RHS at night; day splints as needed
Gentle AROM
Assistive devices and adaptations

Question 12

Rheumatoid Nodules

Answer 12

subcutaneous nodules are an extra-articular characteristic of RA.
Occur mostly on arms, and elbows

Question 13

Trigger finger

Answer 13

tendons thicker, and results in cathing/ snapping in extension

Question 14

Destructive phase of RA

Answer 14

sereve, chronic. Joint deformities ( ulnar drift)

splinting, ROM, assistive devices

Question 15

Chronic phase of RA

Answer 15

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

Question 16

treatment for Chronic phase of RA

Answer 16

assistive devices and adaptations to maintain ADLs

Question 17

4 types of meds:

Answer 17

NSAIDS, steriods, DMARDS, analgesics

Question 18

Swan Neck deformity

Answer 18

hyperextension of PIP and flexion of dip.

Question 19

Boutonniere deformity

Answer 19

flexion of DIP and hyperextension

- Cause is rupture of central slip

Question 20

mallet finger

Answer 20

droop of DIP. damage to insertion of extensor tendon

Question 21

general treatment principles

Answer 21

gentle ROM
stretching intrinsics
heat and cold
joint protection 
pain management