Inflammatory disorders Flashcards
apophysitis
growth centers-similar to epihyseal
insertional tendonitis in the youth
osgood-schlatters (tibial tubercle) and sever disease (calcaneal)
apophysitis tx
cryotherapy, US, TENS, stretching, orthotic (not long term), taping, NSAIDs-not much evidence for any
probably dont want US on growth plate but works-check intensities
acute inflammatory arthritis
abrupt onset
hot swollen, tender jt
could be fever, chills, sweats
rule out mechanical/traumatic injury (could be bursitis, tendonitis, fracture)
differential-infectious, crystaine
chronic inflammatory arthritis
progressive, insidious (> 6 weeks)
morning stiffness > 1 hr
signs of infammation- fatigue, malaise, anhedonia, wt loss, anorexia
extra articular manifesations-rash, urethritis, bowel infection, sicca, uveitis
Rheumatoid arthritis
symmetric, inflamm polyarthritis
women 3x more
autoimmune response
Joint changes with RA
early pannus-grannulation, inflamm at synov membrane, invades jt, softens and destroy cartilage
mod advanced pannus-jt cart disappears underlying bone destroyed, jt surfaces collapse
fibrous ankylosis-fib connect tissue replaces pannus, loss of jt motion
bony ankylosis-callus type tissue.
RA deformities
tenosynovitis
ulnar drift
swan neck deformity boutonniere deformity (could just be tenosynovitis, need to check if both sides)
RA treatment
PT-exercise, heat/cold, e-stem, massage, NSAIDs, accupuncture, DMARDs, corticosteroids, immunosuppresive drugs, jt injections, jt replacement, blood filtering
Gout
high concentration of urate crystals in bood
sx-inflamm/tenderness, pain, redness (usually in foot)
destructive
dx-urine tests, blood tests. gold standard dx is by jt fluid analysis
Gout risk factors
excess alcohol, high BP, high cholesterol, genetics, age, gender (male, post menopausal women)
Gout treatment
medication- NSAIDs, corticosteroids, uric acid lowering meds
adjust diet and alcohol
Pseudogout
calcium pyrphosphate dihydrate crystal in blood
sx-inflamm, tenderbess, redness, jt pain
disruption of cartilage calcification, senior pop
dx-xrays, jt fluid analysis
Pseudogout risk factors and TX
RF- age, jt trauma, genetic disorder, excess iron in blood
TX- NSAIDs, colchicine, jt aspiration, rest
Bursitis
fat pad inflammation
acute-direct injury, normal healing process
chronic- repetitive micro trauma, normally assoc with underlying pathology
Bursitis tx
cryotherapy, US, TENS, NSAIDs, stretching, taping, foot orthotic
not much literature on tx
