Musculoskeletal Flashcards
OA: RF
- Aging
- Obesity
- History of participation in team sports
- History of trauma or overuse of joint
- Heavy occupational work
- Misalignment of the pelvis, hip, knee, ankle, or foot can contribute to the development of osteoarthritic changes
OA only affects which type of joints?
Weight bearing
Cervical, lumbar, Hip, Knee, finger, toes
Patho for OA
- Pressure on joints wears away cartilage
- Cysts develop, they move destroying cartilage
- Chondrocytes make proteoglycan fluid to repair, this causes swelling.
- Localized inflammation
- Osteoblasts activate, producing bone spurs (osteophytes).
- Synovial fluid thickens
- Eventually proteoglycan decreases
- Loss of cartilage= Narrowing of joint space
Osteophytes
Bone spurs
-Hallmark of OA
OA: Symptoms
- Deep, aching joint pain, esp. after exercise or weight bearing, relieved with rest
- Joint pain during cold weather
- Stiffness when arising in the morning
- Crepitus of the join during motion
- Joint swelling
- Altered gait
- Limited ROM
OA physical exam
- Joint deformity
- Joint tenderness
- Decreased ROM
- Fingers are often involved:
- Swelling the distal interphalangeal joint (DIP) Herbeden’s Nodes (tips)
- Proximal interphalangeal joint (PIP), called Bouchard’s Nodes (knuckles)
Herbeden’s Nodes
DIP (finger tip joint)
Bouchard’s Nodes
PIP (knuckles)
OA Treatment
Mild to Mod Pain
- Acetaminophen (liver toxicity)
- Topical capsaicin
- NSAIDs (OTC)
Mod to Severe Pain
- NSAIDs (Rx strength)
- NSAIDS + Colchicine
- Tylenol + Tramadol
- Opioids
- Steroid Injections
Degenerative Disk Disease: S/S in LUMBAR
Lumbar
- Pain in lower back that radiates down the back of the leg (sciatica)
- Pain in the butt or thighs
- Pain that worsens when sitting, bending, lifting, or twisting
- Pain that is minimized by walking, changing positions, or laying down
- Numbness, tingling, or weakness in the legs
- foot drop
Degenerative Disk Disease: S/S in CERVIAL
- Chronic neck pain that can radiate to the shoulders and down the arms
- Numbness or tingling in the arm or hand
- Weakness of the arm or hand
An inflammatory disease of the Synovium
Rheumatoid Arthritis (RA)
RA: RF
Genetic link + Triggering event
- 40-60yo
- Women (2.5x)
- Tobacco
Rheumatoid Factor (RF)
- Auto-antibody against the body’s own antibody IgG
- Formation of immune complexes and activates complement
RA: Pannus
-Inflammatory response from in RA = Cartilage is destroyed by osteoclasts
Pannus develops
-a particular type of scar tissue that is vascularized and contains inflammatory cells
RA: Pannus causes
- Bone erosion
- Bone cysts
- Fissure development
Rheumatoid Nodules
- Immune-mediated granulomas
- Develop around inflamed joints and in lungs
- Subcutaneous, firm
- Sometimes painful
RA: Pharm
- NSAIDS: immediate relief
- Glucocorticoids: Short-term only
- Disease-modifying anti-rheumatic drugs:
(DMARDS) slow the disease progress
-start within 3 months of Dx
In essence Lupis is an autoimmune attack against
The body’s own DNA
2 Major forms of Lupid
- Discoid (skin)
2. Systemic (internal organs)
SLE: Predisposing factors
- Genetics
- Gender
- Age
- Race
- Environmental trigger
- Antibiotic allergy
- Hormonal factors
- Tobacco
In Lupis B-lymphocytes are hyperactive and produce what autoantibody?
Antinuclear antibody (ANA)
- attacks DNA
- Forms immune complexes
SLE: symptoms
- Extreme fatigue
- Photosensitivity
- Butterfly Rash
- Fever
- Weight changes
- Unusual hair loss
- Edema
- Raynaud’s
SLE can cause damage to what organ?
Kidneys (50% of all cases)
Warning signs of flare in SLE
Fatigue
Pain
Headache
Common triggers in SLE
Sunlight
Infection
Stopping Steroids
Stress
Sjogren’s from RA or SLE
Destruction of any moisture producing gland
- Lacrimal Gland
- No tears - Salivary gland
- Dry, red tongue
- Candida
