Rheumatic disease

Question 1

Rheumatic disease

Answer 1

100 different individual diagnoses identified by the pathology of normal muscle, joint, nerve, and connective tissue mechanics

Question 2

Hallmarks

Answer 2

 Subchondral cysts
 Erosions/periarticular sinuses
 Rebuilding of osteophytes
 Severe periarticular bone fragmentation or sinuses
 Ulnar deviation of the (MCP)
 Traces in cartilage-supporting bone tissues
 Eburnation
 Multiple joints that are bilaterally affected

Question 3

Rheumatoid Arthritis

Answer 3

• Causes the synovium to become inflamed and thickened, which results
  in an accumulation of synovial fluid

Question 4

Osteoarthritis-Degenerative joint disease

Answer 4

 Inflammation of bone / joints
 Primary OA: wear / tear over time
 Secondary OA: injury / insult to joint

Question 5

Fibromyalgia

Answer 5

 Widespread pain / tender points
 Fatigue, sleep, memory and mood issues

Question 6

Gout

Answer 6

 Primary impact: 1st metatarsophalangeal joint
 “Unwalkable disease”
 Also impacts: elbows / interphalangeal joints of hands
 Excessive uric acid in the blood of patients

Question 7

Systemic Lupus Erythematosus

Answer 7

 Autoimmune disease where immune system of the body mistakenly attacks healthy
tissue
 Can affect skin, joints, kidneys, brain, and other organs
 Tends to impact similar joints associated with RA

Question 8

Rheumatic Diseases Etiology

Answer 8

 Genetic + eviromental factors
 Formation of synovitis / tenosynovitis if left untreated
 Infectious agents into synovial tissues = chronic inflammation
 Formation of pannus from the synovial lining; substance that
destroys soft tissue

Question 9

OA Etiology

Answer 9

 Polygenic hereditary + environment
 General aging
 Chondropenia
-Loss of cartilage faster than the rate of self-repair
 Degradative enzymes in synovial fluid
-Caused by acute injury, mechanical stress, and even immobilization

Question 10

Fibromyalgia Etiology

Answer 10

 Disabling pain / tenderness; muscles, joints, tendons
 Unclear etiology but believed to be genetics + immunological +hormonal
 Not characterized by joint inflammation and may be a result of how the brain processes pain

Question 11

Gout etiology

Answer 11

 Crystallization of uric acid in joints
 Diet high in purines, rise in blood uric acid
 Hyperuricemia (too much uric acid in the blood)

Question 12

Systemic lupus erythematosus etiology

Answer 12

 Unclear etiology
 Autoimmune disorder
 Impact on joints similar to RA

Question 13

RA prevalence

Answer 13

 Affects 1% of world pop
 Prevalence increases with age
 Dx between age 40 – 70
 Equally affects all races, ethnic groups, gender
 Juvenile rheumatoid arthritis = onset < age 16

Question 14

OA prevalence

Answer 14

 10% - 15% world pop
 Numbers are growing due to aging population and increase in obesity
 ~ 27 million in US
 Knee most common site
 47% women vs 40% men during lifetime

Question 15

Fibromyalgia prevalence

Answer 15

 Often accompanied with RA / OA
 1% - 4.7% worldwide
 More common in women
 US: .5% men vs 3.4% women

Question 16

Gout

Answer 16

 Most common form of inflammatory arthritis
 1% - 4% worldwide
 8.3 million in US
 Men and African Americans mostly affected

Question 17

Systemic lupus erythematosus prevalence

Answer 17

 Frequency decrease of new cases
 Northern Ireland highest prevalence
 Caribbean descent highest incidence / prevalence
 Females 6x > males

Question 18

RA symptoms

Answer 18

 Variable in its onset and progression by individual
 Sudden or gradual, exacerbations and remissions
 Mild symptoms and Severe symptoms
 The inflammatory process is primary source of symptoms
 Fatigue
A swan-neck deformity
A boutonniere deformity
A zigzag deformity

Question 19

OA symptoms

Answer 19

 Localized pain
 Hips, knees, hands, and spines
 Edema / tenderness
 Crepitus during range of motion
 Crunching feeling or sound
 Joint stiffness
 Post-activity flare-up

Question 20

Fibromyalgia symptoms

Answer 20

 Chronic widespread pain
 Point tenderness
 Lower abdomen cramps
 Headaches, fatigue, poor sleep
 Depression
 Signs can occur unilaterally / bilaterally

Question 21

Gout symptoms

Answer 21

-more intermittent vs progressive
 Joint inflammation
 Left untreated = quite destructive
 Edema, erythema, increased localized temp
 Most often big toe affected

Question 22

Rheumatic Diseases Management

Answer 22

• Manage Edema and Pain
• Provide supports and treatment for depression
• Surgery

Question 23

simple procedures

Answer 23

Synovitis issues like trigger finger and carpal tunnel surgery

Question 24

Larger procedures

Answer 24

• Arthrodesis or joint replacement
• Fully remove the damaged bone
• Provide significant pain relief,

Question 25

Rheumatic Diseases Impact on Occupational Performance

Answer 25

• Mobility
• Gripping feeding utensils
• Loss of leisure participation
• Sexual activity
• Pet care
• Work performance