L14: Arthritis Flashcards
what is arthritis
- inflammation of joints or singular joint
- most common: osteoarthritis
is there a treatment for osteoarthritis
nope
what is osteoporosis
- aging is a risk factor
- NOT part of normal aging process
- cartilage destruction can begin between ages 20-30
- few pt experience sympt until after age 50-60
2 categories of arthritis
- idiopathic disorder
- secondary disorder
what does OA result in
- cartilage damage that triggers a metabolic response
- cartilage erodes at articular surfaces of joint
- bone spurs (osteophytes) may form
in OA what does cartilage become
- dull, yellow, and granular
- soft and less elastic
- less able to resist wear w heavy use
what is NOT a characteristic of OA
secondary synovitis may result
3 stages of OA manifestation
stage 1: predictable, sharp
stage 2: more constant, affecting daily activities
stage 3: constant dull/aching pain
crepitation
grating sensation due to loose particles of cartilage
does OA affect the joints asymmetrically or symmetrically
asymmetrically
what is the main restriction of OA
mobility restriction
heberden’s nodes
DIP joints
- osteophyte formation and loss of joint space
- can appear as early as 40 yrs
bouchard’s nodes
PIP joints
- similar disease involvement as heberden’s nodes
bow-leggedness
medial knee joint
- joint deformity
knocked-kneed
lateral knee joint
- joint deformity
diagnostic studies of OA
- bone scan, MRI, CT (detect early joint changes)
- x-ray
- inflammatory markers (erythrocyte sedimentation)
- synovial fluid analysis
clinical diagnosis of OA
- persistent joint pain for 1 or more joints
- age greater or equal to 45 yrs
- morning stiffness less than or equal to 30 min
collaborative care of OA
- no cure
- non-pharmacological interventions
- pt education and self-management
- drug therapy is considered adjunct therapy
- reconstructive surgery
drug therapy for OA
- NSAIDS (oral and topical): PPI’s, topical: one or a few joints only, oral: celebrex
- capsaicin cream (1 or few joints involved)
- tylenol (not more than 4g/day)
- duloxetine (multiple joints)
- corticosteroids (intra-articular injections of corticosteroids)
- hyaluronic acid injection
- doxycycline (decreased joint deterioration **investigational)
rheumatoid arthritis
chronic, systemic autoimmune disease characterized by inflammation of connective tissue in the diarthrodial (synovial) joints, typically w periods of remission and exacerbation
- early recognition and treatment are key
rheumatoid arthritis etiology
is unknown: possible autoimmune, enviro triggers genetic endowment, genetic factors, antigen triggers to form abnormal immunoglobulin G
how is RA characterized
- by the presence of autoantibodies against abnormal IgG - known as rheumatoid factor
does RA occur asymmetrically or symmetrically
symmetrically: affects small joints of hand and feet (PIP and MTP joints)
extra-articular manifestations of RA
- flexion contractors and deformity
- rheumatoid nodules
- sjögren’s syndrome
- felty’s syndrome