Other broad conditions Flashcards
What is Osteoarthritis?
A degenerative joint disease or inflammation of a bony joint.
Usually when the cartilage or other structures about a joint have been broken down or there has been a structural change
Risk factors of OA?
- Age
- Overweight
- Previous trauma or injury in the area
- Repetitive overload
How does OA of the wrist/hand/ thumb present?
- Crepitus
- Nodules at the DIP or PIP joints
- Swelling around the joints
- Squaring at the base of the thumb
- Thenar eminence wasting
- Commonly affecting DIP and PIP
How does OA of the shoulder present?
- Crepitus
- Pin point pain
- Deep aching in the joint
- Loss of ROM
- Difficulty in ADL’s
What is tendinopathy?
A general term to describe tendon degeneration caused by overuse which leads to poor tendon repair making the tendon more susceptible to micro-tears and degeneration.
- Commonly affects rotator cuff, wrist extensors/flexors, patella tendon, achilles tendon
- Cook and Purdam (2009) proposed a tendon pathology continuum which includes reactive tendinopathy, tendon disrepair and degenerative tendinopathy.
Signs and symptoms of a tendinopathy?
- Pain and tenderness on palpation of the affected tendon
- Stiffness, especially in the morning
- Aggr: exercise
- Reduced ROM of the affected joint
Management of tendinopathy
- Progressive tendon loading
- Eccentric exercise alongside stretching, isometric, electrotherapy, manual therapy or deep transverse friction massage is most effective
- Surgery only if conservative treatment hasnt helped after 6-12 months
Lorana Carro et al
Management of OA generally
- Exercise: FITT principle
- Physical therapy
- Neuromuscular electrical stimulation has little effect
- Acpuncture requires further research
How does OA of the hip present?
- Pain in groin, hip, buttock and thigh
- Stiffness in capsular pattern
- Stiffness
- Aggr factors: walking, putting socks on, climbing stairs
- Muscle wasting in glutes
- Positive trendelenberg sometimes
How does OA of the knee present?
- Global anterior pain as well as joint line pain
- Stiffness
- Crepitus
- Swelling
- Restriction to flexion and extension
- Aggr: walking, squatting, stairs, bending
How does OA of the ankle present?
- Ankle joint pain
- Mostly affects one joint but can occur bilaterally
- Aggrs factors: weight bearing
- Stiffness
- Crepitus
Stages of the tendon pathology continuum
Reactive tendinopathy- brought about by over-load. The tendon can revert back to its normal state
Tendon disrepair- due to consistent overload and regression back to normal state does not occur
Degenerative tendinopathy- the changes are now irreversible as there is cell death, trauma and reduced tenocyte activity causing disorganisation within the tendon cell matrix
