OA Vs RA

Question 1

Gradual loss of articular cartilage caused by DJD

Answer 1

OA

Question 2

Pathology of OA and RA

Answer 2

Older women

Question 3

Clinical sx of OA

Answer 3

Pain
Stiffness
Swelling

Question 4

Most commonly affected OA joint

Answer 4

1st CMC/basal joint of thumb

Question 5

Heberden’s nodes in OA

Answer 5

Bony enlargements of DIP joint

Question 6

Bouchard’s nodes

Answer 6

Bony enlargements of PIP joints

Question 7

What limited with basal joint arthritis

Answer 7

Pinching and gripping

Pain with handwriting - drops things often

Question 8

Conditions associated with OA

Answer 8

Carpal tunnel syndrome
Dequervians
Trigger fingers
Wrist ganglions

Question 9

Typical x ray findings on OA

Answer 9

Narrow joint space
Osteophytes
General outline of joint still there
Normal bone texture

Question 10

Most common fixed deformities of OA

Answer 10

DIP flex
CMC add
Thumb MCP flex/extend

Question 11

How do you assess thumb stability for OA?

Answer 11

Tip to tip pinch while holding IP and MCP of thumb in neutral

Question 12

Grind test for OA

Answer 12

Compress MCP onto trapezium and rotate

Question 13

Goal of conservative txt for OA

Answer 13

Preserve comfort and joint function

Question 14

What does a trigger finger splint do

Answer 14

Block MCP flex

Question 15

What do finger troughs do?

Answer 15

Support the joint and prevent further deterioration

Question 16

Post surgical therapy for OA

Answer 16

Immobilized for 4 weeks in cast
Thumb spica splint for 2 weeks
Starts AROM (avoid full ADD in thumb)

Question 17

Systemic disease that attacks the synovium

Answer 17

RA

Question 18

Very common complaint in RA

Answer 18

Fatigue q

Question 19

Goal of conservative txt in RA

Answer 19

Minimize Sx, prevent joint deformity

Question 20

Swan neck deformity

Answer 20

Hyperextension of PIP

Flexion of DIP

Question 21

Boutonnière deformity

Answer 21

Hyperextension of DIP and flexion of PIP

Question 22

What’s gutter splint for

Answer 22

Synovitis

Question 23

Which deformity is the one to have static vs dynamic?

Answer 23

Boutonnière

Question 24

Ulnar drift

Answer 24

At MCP joint where EDC slips to ulnar side of it so tendon is no longer centralized

Question 25

Advanced forms of ulnar drift

Answer 25

Zig zag and subluxation of MCP

Question 26

What is zig zag deformity for RA

Answer 26

Radial deviation at wrist

Ulnar deviation at MCP

Question 27

Goal for arthroplasty for RA

Answer 27

70 deg of MCP flex and neutral extension by week 3

Question 28

What tool do you want to avoid with PIP arthroplasty and why?

Answer 28

Coban wrap b/c it might twist on the joint when you remove wrap

Question 29

RA at the wrist begin with

Answer 29

Synovitis

Question 30

What dont you want to try with PIP arthroplasty

Answer 30

Dont do ROM past 80 deg because you can fracture prosthesis?

Question 31

Which lig does RA attack most common

Answer 31

Scapholunate

Question 32

Total wrist arthrodesis fused at

Answer 32

10-20 deg of wrist extension

Question 33

Partial wrist arthrodesis fused at

Answer 33

0-15 deg

Question 34

Which wrist arthrodesis is in cast longer for 6-10 weeks

Answer 34

Partial wrist