joint disorders 1 Flashcards
chondrolysis
narrowed joint space due to rapid cartilage degeneration
(leads to loss of ROM)
3 causes of chondrolysis degeneration
infection
trauma (like surgeries)
prolonged immobilization
which joint does chondrolysis most commonly occur? which population is most susceptible?
HIP
slipped capital femoral epiphysis (SCFE)
adolescent females
osteoarthritis
slow degenerative joint disease that breaks down cartilage, bone, then soft tissues + synovial fluid
primary vs secondary OA
primary: unknown cause
secondary is caused by: trauma, infection, hemarthrosis, osteonecrosis, etc.
what is the most common joint disease
osteoarthritis
The development of OA is a risk factor for also developing….
cardiovascular disease
biggest difference between OA and RA
OA typically shows sign in one joint while RA attacks symmetrically
creptius
audible crackling or grating sensation produced when moving joint
OA of the hand affects which 2 joints the most
DIP and PIP
osteophyte
bone spur
heberden nodes
OA affecting DIP
bouchard nodes
OA affecting the PIP
Kellgren and Lawrence grade 1
possible osteophytes
no joint space narrowing
Kellgren and Lawrence grade 2
definite osteophytes
possible narrowing of joint space
Kellgren and Lawrence grade 3
moderate multiple osteopytes
definite joint space narrowing
some sclerosis and possible deformity of bone ends
Kellgren and Lawrence grade 4
large osteophytes
marked joint space narrowing
severe sclerosis and definite deformity of bone ends
what PT techniques are beneficial for OA
maintaining joint mobility and ROM
Eccentric contractions
Closed chain strengthening
characteristics of rheumatic disease
- can affect WHOLE BODY
- episodic (exacerbation and remission phases)
second most prevalent form of arthritis
rheumatoid arthritis
what 2 other autoimmune diseases is RA associated with
Graves disease
Hashimoto thyroiditis
Rheumatoid factors
autoantibodies that react
with immunoglobulin antibodies found in the blood
how does synovitis occur in RA (3 steps)
synovial lining increases –> WBC increases –> synovium becomes edematous
pannus
destructive vascular granulation tissue
synovium has 2 primary functions:
- lubricating joint
- provides nutrients to avascular articular cartilage
in RA, elevated cytokines inhibit ______ and activate ______
bone formation
osteoclasts
ankylosis
adhesions and fibrous/bony fusion of the joint
what happens to the tendons and ligaments in a joint with RA destruction
LAXITY
swan neck deformity
hyperflexion of DIP
hyperextension of PIP
boutonniere deformity
hyperextension of DIP
hyperflexion of PIP
2 finger deformities common in RA
swan neck
boutonniere
the longer a person has RA, the higher likelihood they will have disease/degeneration of the ______
cervical spine
why is upper cervical spine the most affected in RA
C0-C1 and C1-C2 articulations are PURELY SYNOVIAL
what complication can occur with anterior subluxation of C1-C2
spinal cord compression (by the dens)
where do RA cutaneous granulomatous lesions usually occur
areas of repeated mechanical pressure
ex: elbow, achilles tendon, extensor surfaces of fingers
nodulosis
subcutaneous nodules in RA
what is the cause of compressive cervical myelopathy
laxity of the transverse ligament caused by RA
how do peripheral neuropathies occur
nerves become compressed by inflamed synovia in tight compartments
rheumatoid vasculitis involving medium-sized arteries can lead to
mononeuritis multiplex
small vessel vasculitis
brown infarcts found on the palm and fingers of patients with RA
most common surgery for RA in the hand
tenosynovectomy
what joints typically affect patients with RA? Is it symmetrical or asymmetrical presentation?
small joints of feet and hands
SYMMETRICALLY
3 major signs of RA
- symmetrically affected joints of the feet/hands
- unexplained joint pain with SYSTEMIC SYMPTOMS (rash, nodules)
- insidious onset of polyarthritis/joint pain after taking new meds or having an infectious disease
age of OA vs RA
OA: 40+
RA: 25-50
is C-reactive protein present in pts with OA or RA?
RA
it is an indicator of systemic inflammation
