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68wm6 p2 Inf Dis Mus
Inflammatory Disorders of the Musculoskeletal System
| Question | Answer |
|---|---|
| What is Arthritis? | General condition characterized by inflammation and degeneration of a joint |
| What is Rheumatoid Arthritis? | A systemic inflammatory disorder of connective tissue/joints. Characterized by chronicity, remissions, and exacerbation. Thought to be an autoimmune disorder. |
| What is found in 70% - 80% of people with rheumatoid arthritis? | The antibody Rheumatoid factor (RF) |
| What is the progression of rheumatoid arthritis? | attacks small joints early and involves large joints later |
| Who is at most risk for rheumatoid arthritis? | Mostly women, in reproductive years of early adulthood, usually 20 to 40 years of age |
| What happens to the joint in rheumatoid arthritis? | *Synovitis as congestion and edema develop in the synovial membrane and joint capsule *Synovial fluid suufers reactive hyperplasia *Vasodilation and inc blood flow cause warmth and redness *Pannus formation (destructive vascular granulation tissue) |
| List 5 localized S/Sx of rheumatoid arthritis: | *Joint pain (early complaint) *Stiffness (early complaint) *Swelling *Warmth *Erythema *Mobility limitations *Spongy tissue on joint palpation *Accumulation of fluid on joints |
| List 5 systemic S/Sx of rheumatoid arthritis: | *Sjogren's syndrome *Fatigue *Malaise *Anorexia *Weight loss *Fever *Vasculitis *Neuropathy *Pericarditis *Splenomegaly *Anemia |
| What are the 4 'classic' S/Sx of rheumatoid arthritis? | *Morning stiffness *Joint pain *Muscle weakness and atrophy *Fatigue |
| Why were cyclo-oxygenase type 2 (COX-2) inhibitors discontinued in use for rheumatoid arthritis? | There are currently a number of class action lawsuits due to cardiovascular complications associated with COX-2 inhibitors |
| What is given if there are bony erosions associated with rheumatoid arthritis? | methotrexate (Rheumatrex), an anti-neoplastic agent |
| What immunosuppressants are used only in SEVERE cases of rheumatoid arthritis? | Cyclosporine (Neoral) and Azanthioprine (Imuran) |
| What injection is given that acts as a lubricant, substituting for hyalonuric acid, the substance that provides joint tissue viscosity? | viscosupplement (Hyalgan, Synvisc and Supartz) |
| Why are PTs with rheumatoid arthritis encouraged to frequently gently move joints affected with RH? | to lessen the possibility of ankylosis, muscle wasting, osteoporosis, and debilitating effect of prolonged reset |
| What is Degenerative Joint Disease? | (AKA Osteoarthritis) A non-systemic, non-inflammatory disorder that progressively causes bones and joints to degenerate |
| What Joints does Degenerative Joint Disease typically affect? | the weight-bearing joints |
| How does Degenerative Joint Disease differ from rheumatoid arthritis? | DJD has no remission periods, and no systemic symptoms (such as the malaise and fever seen in our RA patients) |
| List 4 S/Sx of Degenerative Joint Disease: | Joint stiffness and pain Joint enlargement Limitation of joint movement *Herberden's nodes *Bouchard's nodes *Progressive limitation of ROM in affected joint |
| What are Herberdens Nodes? | enlargement of distal interphalangeal joints, associated with osteoarthritis |
| What are Bouchard's nodes? | enlargement of Proximal interphalangeal joints, associated with osteoarthritis |
| How should the legs be positioned for a post-op hip replacement PT? | Abducted and extended |
| When a post-op hip replacement PT is OOB, how should they be seated in a chair? | in a seat raised by pillows so that the hip flexion remains less than 90 degrees |
| What is Gout (gouty arthritis)? | A metabolic disease resulting from an accumulation of uric acid in the blood (hyperuricemia) |
| List 4 S/Sx of Gout: | *Sudden onset of pain and tenderness in one joint (commonly the great toe) *Swelling, and redness of the joint *Joint becomes hypersensitive to touch *Fever *Presence of Tophi *Joint deformities |
| What will be in the synovial fluid in a PT with gout? | urate crystals |
| What should be decreased in the diet in a PT with gout? | Purine |
| What is Ankylosing Spondylitis (Marie-Strumpell Disease) | A chronic connective tissue disorder of the spine and surrounding cartilaginous joints that leads to a loss of curvature in the spine and Immobility and fixation (Ankylosing) of the joints in the hip and ascends the vertebrae |
| What are the systemic effects of Ankylosing Spondylitis? | *Respiratory functions may be compromised when kyphosis develops *Inflammation of the aorta (aortitis) *Iridocyclitis *Pulmonary fibrosis |
| What is Iridocyclitis? | inflammation of the iris and ciliary body of the eyes |
| What is found in 90% of PTs with Ankylosing Spondylitis? | Human leukocyte antigen A (HLA-B27) |
| What can the PT with Ankylosing Spondylitis do to help extend the spine? | Lie on the abdomen for at least 15-30 minutes QID |
| Why is it so important to the patients with Ankylosing Spondylitis to follow a prescribed exercise program? | an exercise program may help delay or prevent spinal deformity, especially if begun in the early stages of the disease |
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Shanejqb
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