RA and other things Flashcards
when is the age of onset for OA
normally after 40 yo
what is the progression of OA like
occurs slowly over many years in response to mechanical stress
how does OA manifest
cart degradation, altered joint artecture, osteophyte formation
joint involvement for OA
DIP, PIP, 1st CMC, 1st MCP
cervical and lumbar spine
hips, knees
systematic signs for OA
none
RA age of onset
15 -50
RA progression
suddenly within weeks or months
manifestations of RA
inflammatory synovistis and tenosynovistis
ersion of the cart, bones and ligaments
joint involvement of RA
many joint normally symmetric
MCP, PIP, MTP
wrist, elbow, shoulder
C-spine
talonavicular and ankle
signs and symptoms of RA
redness
warmth
swelling
prolonged morning stiffness
increased pain with activity
signs and symptoms of OA
morning stiffness < 30 mins
pain with weight bearing
crepitus
loss of range of motion
systematic signs of RA
weight loss
fever
fatigue
rheumatoid nodules
ocular
hematological
respiratory and cardiac features
systematic effects of rheumatoid disease
fatigue
cardiac and respirtory symptoms
neuropathy
anemia
what are some examples of rheumatoid diseases
RA
Lupus
scleoderma
ankylospondylistis
fibromyalgia
unstable joints and resistance exercises
unstable joint may not tolerate resistance exercises
what is a nodule at the elbow
bump at the elbow
when a joint is unstable what plane of motion should they be moved
in a single plane of motion
how can we accomplish joint specific rest
with the use of of AD or splints
knee OA - what part of the knee joint
the entire thing
art cart, synovium, bone , soft tissue
capsular pattern for the knee
flex > ext
what are some risk factors for OA
genetics
age
BMI
bone shape
AFAB
are there different approaches for knee replacements
traditional - 8-10 inch incision
minimally invasive approach - 4-6 inch incision, quad sparing
what kind of patient is the min invasive approach good for
lower BMI
younger
limited co-morbities
motivated for the rehab process
prognostic factors for TKA
BMI
depression
pre-op ROM
physical function and stregnth
age
DM
comorbities
sex
pre -op exercises
focused on strengthing and flexibility
CPMs and post op
do not use them
cyrotherapy and post op TKA
good use for pain managment
NMES and post-op TKA
pt should use NMES to improves quads muscle strengths and other things
KOOs score
0-100
0 - problems
100 - no problems
STS scores
the teens are the cut off score for most adults
TUG cut off score
> 13.5*for community dwelling adults
joint involvmenet OA
asymmetrical
medical management for OA
low impact exercise - biking and swimming
stretching to increase ROM of the effected joint
avoid activities that do not allow for a change in position
heat for pain relief
medical management for RA
avoid high load activities - jumping and running
orthoese or splint for joint protections
mod activities to require less energy
heat for pain relief , caution when the pt is experiencing a flare up
is there are single test to diagnose RA or OA
no
diagnosis is mainly based on the symptom presentation, labs, imagaing
what is scleroderma
a systemic disease due to progressive fibrosis of the skin, vasculature, and internal organs
is scleroderma progressive
yes
what population does scleroderma occur in
women
30-50
what are the symptoms of scleroderma
thickened tight skin
tiff hypomobile joints
muscle shortening and weakness
educed sweating
what is diffuse cutaneous scleroderma
rapid progression that extends proximally
early pulmonary fibrosis
high risk of cardiac and renal involvement
what is limited cutaneous scleroderma
CREST
C - calcinosis
R- raynauds
E - esophageal dysfunctions
S - sclerodactyly
T - telengiectasis
what is Calcinosis cutis
condition in which calcium salts are deposited in the skin and subcutaneous tissue
what is sclerodactyly
a hardening of the skin of the hand that causes the fingers to curl inward and take on a claw-like shape.
what is telengiectasis
small, widened blood vessels on the skin.
what is raynauds
small art constrict in response to the cold - limiting the blood supply to affected skin areas
what can you do to prevent raynaud’s
self care - dress warmer
anti-HTN drug
CA blocker used to promote vasodilation
how do we medically diagnosis scleroderma
CBC
anti-body levels
creatine levels
history
pulmonary function tests
CT
skin biopsy
is therapy considered safe in those with scleroderma
yes it is safe
what is lupus
chronic autoimmune disease that effects the entire body
- skin, joints, heart, lungs, kidneys, etc.
how does lupus present
periods of illness and periods of wellness
women and lupus
women are 9x more likely to have this
more common in black people
sym of lupus
butterfly rash
fever
fatigue
raynuads
swelling
what is the fatigue severity scale
scale that can be used to measure fatigue
what is fibromyalgia
chronic disorder that causes msk pain and tenderness throughout the body
accompanied by fatigue, sleep, memory, and mmod issues
medical managment of fibromyalgia
medicaltions
therapy - pt, ot, consueling
self care - stress management, sleep stratgies, regular exercise
location of most fibro pain
superior chest
back
calves
ant and post knee
what is one of the leading causes of hip dislocation
cog impairment
risk factors for hip joint dislocation
pt age and when they had surgery
small dia of femoral head
history of instability
number of previous revisions
what are poetential complications of chronic hip dislocation
nerve damage
osteonecrosis
arthritis
stretched out ligament and capsule
PL approach for hip replacement
most common approach
the abd muscle is not cut
PL approach precautions
no past mid line
IR
flex > 90-deg
do not roll on unprotected side for 6-weeks - sleep on back for the first 6 weeks
lateral approach
split glute med and vastus lateralis
less chance of nerve damage and dislocation
anterior approach
incision is made near the front of the hip
discharged sooner
less precautions
min invasive hip replacement done in what population
more active
younger
motivated to particpate in rehab
