MS part 2: arthritis Flashcards
synovial joints
-most joint disorders affect synovial joints
-a synovial joint is composed of an outer fibrous capsule, interior synovial membranes, articular cartilage, and synovial fluid
-the bones come together and move easily because of the smooth surfaces of articular cartilage and lubricating synovial fluid
arthropathy
a joint disorder is termed arthropathy when the disorder involves inflammation of one or more joints
Osteoarthritis
-degeneration of joints caused by aging and stress
common joints affected by OA:
-cervical spine
-lumbosacral spine
-hip
-knee
-hands
-first metatarsal phalangeal joint (big toe)
OA risk factors:
-aging
-obesity
-history of participation in team sports
-history of trauma or overuse of joint
-heavy occupational work
-misalignment of pelvis, hip, knee, ankle or foot
OA etiology
-stress applied to joint
-degeneration of cartilage
-chronic disease
OA patho
-prolonged excess pressure on joint wears away cartilage and subchondral bone exposed- leads to cyst development
-cysts move through remaining cartilage and destroys the rest
-localized inflammation lead to more degradation
-chondrocytes synthesize fluid called proteoglycans to try and repair-causes swelling
-osteoblast activation leads to bone spurs and synovial fluid thickening
-loss of cartilage narrows the joint space
manifestations of OA
-deep, aching joint pain, especially with exertion
-joint pain with cold weather
-stiffness in morning
-crepitus of joint during motion
-joint swelling
-altered gait
-limited ROM
OA exam findings
-joint deformity
-joint tenderness
-decreased ROM
-fingers often involved- herbeden’s nodes (distal) and bouchard’s nodes (proximal)
treatment for OA:
-goal to manage pain and reduce swelling
-mild to moderate: tylenol, topical capsaicin, NSAIDS
-moderate to severe: NSAIDS+ colchicine, tylenol+tramadol, opioids, steroid injections
degenerative disc disease (DDD)
-common cause of pain, motor weakness, and neuropathy
-most often occurs in cervical or lumbar spine
S/S of DDD- lumbar
-pain in lower back that radiates down the back of the leg
-pain in buttocks or thighs
-pain that worsens when sitting, bending, lifting, or twisting
-pain that is minimized when walking, changing positions, or lying down
-foot drop
-numbness, tingling or weakness in legs
S/S of DDD- cervical
-chronic neck pain that can radiate to the shoulders and down the arms
-numbness or tingling in the arm or hand
-weakness of arm or hand
degenerative discs
-motor and sensory spinal nerves enter and exit from the spinal cord and travel through narrow openings of the vertebral bone
-with age, intervertebral discs dehydrate and vertebral bone become compressed- impinge on the entering and exiting nerves
RA
-systemic, autoimmune disease
-type III hypersensitivity
-inflammatory disease of synovium
