MS Conditions Flashcards
Your patient comes to you with a diagnosis of DJD, and they don’t know what that is. How would you explain it to them?
degenerative joint disease, also known as osteoarthritis, is a degeneration of the cartilage in weight-bearing joints
- also known for hypertrophy of subchondral bone and joint capsule
Can be due to mechanical changes over time, joint trauma, or disease
You’re chart reviewing for a patient with ankylosing spondylitis. What is this condition, and what can you expect to see?
rheumatoid disease; progressive inflammatory condition that affects axial skeleton
- kyphotic deformity of the c and t-spines, with loss of lordosis in lumbar spine
- might have mid/low back pain, morning stiffness, sacroilitis
What meds can be taken for ankylosing spondylitis?
NSAIDs (since inflammatory), corticosteroid therapy or meds to suppress immune system
What’s the first line of medication treatment for OA?
NSAIDs; glucocorticoids can be shot into joints that don’t respond
ER at the femur causes what motion at the tibia?
ER - think coupling patterns
T/F: Morning stiffness is pretty typical with DJD.
false, usually not too bad but if so does go away within 4-5 hours (?! conflicting statements in book)
T/F: People with OA tend to feel better with exercise.
true - TELL THEM THIS
What kinds of meds are people on for OA?
NSAIDS
T/F: Fibromyalgia is considered an immune disorder.
true - immune involvement with issues of mood, sleep
How might patients with fibro describe their pain?
aching, burning
diffuse pain all over
What are PT’s goals with DJD patients?
1) provide joint protection strategies (think of lifting, getting in/out of car, etc)
2) maintain/improve joint mechanics and strength
3) aerobic exercise conditioning to limit sedentary life that results in further joint limitations
What should be a big component of fibro treatment?
aerobic exercise training
improve sleeping patterns
stress management (journaling, tai-chi/yoga)
What does gout most often affect?
feet
- esp. great toe, ankle, and mid-foot
T/F: People with gout get intense joint pain in the mornings.
false, at night: warmth, redness, extreme tenderness
How is gout managed?
with anti inflammatory meds, and colchicine
- need to lower urate concentration in body fluids with diet, weight loss, and moderation fo alcohol intake
What can PT do for gout?
- educate on lifestyle: need to have a healthy diet, lose weight, and drink alcohol sparingly to decrease this pain
- rest, elevate, and protect joint of injury during acute phase
How would PT intervene for an acute injury for a patient with hemophilia? What are the concerns?
initial concerns: bleeding into joint/muscle, causing deformity and/or decreased mobility
- bleeding near peripheral nerves or arteries can cause neuropathies, ischemia, etc
SO for treatment:
- ice, rest, elevation in acute stage; splint
For a chronic injury with a hemophiliac, what does PT do?
enforce daily ROM exercise
ADL training
maintaining joint function/protection
splints/ADs if needed
What interventions wouldn’t be appropriate for patients with hemophilia?
stretching (d/t risk for myositis ossificans)
T/F: An excessively externally rotated hip during stance is indicative of a IT band syndrome.
false, excessively internally rotated
Where are frequent locations for myositis ossificans to occur?
quads
biceps brachii
brachialis
What is osteochondritis dissecans?
separation of articular cartilage from underlying bone (osteochondral fracture)
What is the difference between osteoporosis and osteomalacia?
osteomalacia = decalcification of bones d/t lack of vitamin D
osteoporosis = metabolic disease that depletes bone mineral density/mass
What location is most common for osteochondritis dissecans?
medial femoral condyle
- occasionally at femoral head and talar dome
After surgery for osteochondritis dissecans, what are PT’s main goals?
improve aerobic conditioning post surgery
gait training
functional training/strengthening
What is Paget’s disease?
slowly progressive metabolic bone disease
- sites of excessive bone reabsorption followed by excessive abnormal bone formation
- these sites are unstable, prone to fx (often in spine, pelvis, femur, skull)
What is the expected Q-angle for a patient with patellofemoral dysfunction?
> 18deg
McConnel’s taping technique is useful for what diagnosis?
PFP
Raynaud’s phenomenon often accompanies what disorder?
scleroderma
What are the first signs of scleroderma?
heart burn, dyspnea, polyarthralgia
