JIA, Achondroplasia, arthrogryposis, OI Flashcards
Juvenile Idiopathic Arthritis (JIA)
Encompasses all forms of arthritis before age 16 that lasts > 6 weeks and is of unknown origin
Chronic disease characterized by inflammation of the lining of the joints
Cause of JIA
Unknown, thought to be autoimmune
**diagnosis of exclusion
Symptoms of JIA
Joint stiffness + pain
Limited ROM
Joints may be warm or swollen, sometimes red
Decreased use of affected limb + limp while walking
Systemic complications of JIA
Inflammation of eye (iridocyclitis)
High fever
Rash
Classifications of juvenile arthritis
Classified by # of joints involved during 1st 6 months of diagnosis
Oligoarticular < 4 joints
Polyarticular > 5 joints
Systemic (affects the whole body, includes fever and other systemic symptoms)
Diagnosis of JIA
MRI
RF factor
Treatment of JIA
Medications
PT
Regular exercise
Surgery
Meds for JIA
NSAIDs
Corticosteroids
Methotrexate
Humira + Enebrel
Integumentary signs of JIA
Rash
Nodules
Edema
MSK exam of JIA
Joint status + integrity
ROM
Postural alignment
Leg length discrepancies
Joint deformities
Muscle function
Cardiopulm + JIA PT exam
Vital signs at rest + with activity
RPE scales
JIA PT Exam + function
Gait pattern + parameters
Transitions
Self care
Gross motor abilities
Assistive devices
Motor assessments for JIA
PDMS 2 + 3
BOTMP 2
PT intervention for JIA
Relieve pain
Minimize inflammation
Prevent limitation + restore ROM
Maintain + increase muscle strength
Increase + maintain endurance
Promote normal growth + development
Optimize health
Swimming
Intervention during active flare up of JIA
Prevent contracture
Customized resting splints + positioning
Pain management
Avoid full bed rest, be as mobile as possible
Intervention of chronic JIA
ROM to increase flexibility and decrease stiffness
Preserve max functioning with positioning
Functional splints to protect joints during activity
HEP
Modalities: caution with growth plates
Regular exercise: stretch before, low intensity
Therapeutic exercise and JIA
Strengthen, improve endurance, and decrease burden on joints
-Isometrics
-AROM
-Aquatic therapy
-mod intensity aerobic conditioning <30 min
Overall goal of JIA
Increase muscle strength to decrease stress on joints
Contraindications to physical activity in JIA
Fever
Anemia
Acute renal failure
Carditis
Serositis
Ischemic response to treadmill test
Non controlled arrhythmias
arterial HTN
malnourishment with weight loss > 35%
Prognostic indicators for JIA
polyarticular JIA + positive RF have worse prognosis
symmetrical joint involvement
Severe arthritis at onset
Early signs of wrist + hip involvement
Complications of JIA
Leg length discrepancy
Changes in bone density
Achondroplasia
Genetic disorder the affects skeletal development characterized by severe disproportionate short stature
Cause of achondroplasia
Mutation in the gene that codes for fibroblast growth factor
Symptoms of achondroplasia
Disproportionate body size w large head
Occipital bossing
Shorter limbs
Loose joints
Hypotonia
Bowing of lower legs
Normal intelligence + life expectancy
Other risks of achondroplasia
Hydrocephalus
Craniocervical junction compression
Upper airway obstruction
Thoracolumbar kyphosis
Biomechanical considerations/precautions for achondroplasia
Avoid flexion posture of neck and spine
Avoid too much neck bending in any direction
Scott sign
Clinical measure of ligamentous laxity defined by passively opposing lateral borders of the feet when brought together in midline above the level of the pelvis in seated position
