physical assessment in RA Flashcards
active joint count is a measure of__
inflammatory activity
three criteria for an active joint
effusion
joint tenderness
stress pain
does it matter which order you assess three criteria
yes - do sequentially
children joint assessment criteria
swelling OR
limitation of motion with heat, plus over pressure pain OR joint line tenderness
STOP Method for active or inactive joint
swelling
Tenderness
OP over pressure
stop at any point it is positive
effusion
fluid confined by joint but freely mobile in that space
techniques for effusion
two thumb
four finger
bulge sign
difference between fatty tissue and effusion
fatty: soft but fixed in location, outside of joint capsule
effusion: fluctuation in all planes
do bony enlargement / joint deformities constitue joint swelling
no
two thumb technique
thumb on both sides, press w one
four finger technique
fingers above collateral ligaments
how to joint tenderness
pressure on joint line
how to do stress pain
stretch of inflamed capsule
over press at end of PROM
is damaged joint easy to define
no
bony erosion of ___ for TMJ
mandibular condyle
end stage of TMJ disease may result
fusion in open bite
TMJ involved in early or late disease
late
how to do TMJ assessment
joint count
ROM
palpation
RA in C spine is common or uncommon
common
most commonly c spine area effected
c1-2 atlantoaxial
progression of instability in C spine associated with
steroid used
seropositive disease
RA nodules
atlantoaxial sublaxation
stretch / erosion of transverse ligament
erosion of dens / superior facet of atlas
traverse ligament fails to check c2 movement
signs of atlantoaxial sublaxation
pain, suboccipital headache
heavy head sensation
clunking
dizzy, blurred vision, dysphasia
can atlantoaxial sublaxation be asymptomatic
yes
C spine assessment subjective
screening questions 5 Ds
behaviour of their symptoms (clicking , heavy ahead, pain)
c spine assessment objective
MSK upper quadrant screen(cranial nerve, myo, derms, reflexes)
special test for cervical spine
whats compromised in atlantoaxial subluxation
SC
vert artery
do you test stability of C spine if decreased ROM, or 3n, 5D
no go see Gp
if no adverse response from objective assessment, rule out anterior instability with
sharp purser // anterior shear stability test
hallux valgus is synovitis of
1st MTP
MTP sublimation is displacement of flexors or extensors
flexors
claw toe is weakness of
intrinsics
claw toe
MTP extension, PIP and DIP flexion
hammer toe is synovitis of
MTP and PIP
flexion of PIP
of DIP
mallet toe is
flexion of DIP
