NPTE Musculoskeletal
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| DJD Characteristic findings | 1. Diminished joint space. 2. Decreased articular cartilage height. 3. Osteophytes.
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| DJD PT goals | 1. Joint protection strategies. 2. Improve joint mechanics & CT function. 3. Aerobic/endurance conditioning
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| Progressive inflammatory DI of unknown etiology that initiall affects axial skeleton | Ankylosing spondylitis
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| Ank Spond Onset age | Age-before 4th decade. Ank Spond sex
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| Ank Spond initial sx | Sx- mid & low back pain >3m, morning stiffness, sacroiliitis
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| Ank Spond results in | Cx and Tx kyphosis and decreased Lx lordosis. Degeneration of peripheral & costovertebral joints in adv.
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| Ank Spond meds used | NSAIDS, Corticosteroids, Cytotoxic drugs, TNF inhibitors (may improve sx)
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| Ank Spond Dx test | HLA-B27 helpful but not diagnostic
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| Ank Spond PT goals | trunk flexibility esp EXT, aerobic conditioning, relaxation and breathing strategies to maintain resp function
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| Genetic DO of purine metabolism with elevated uric acid. UA turn to crystals and deposit in joints and kidneys | Gout
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| Gout most observed in | knee & big toe
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| Gout meds | NSAIDS, COX2, colchicine, corticosteroids, ACTH, allopurinol, probenecid, sulfinpyrazone
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| Gout PT goals | education, early ID
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| Chronic, erosive inflammatory degeneration in digits and axial skeleton assoc with psoriasis | Psoriatic arthritis
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| Psoriatic Arthritis meds | NSAIDs, corticosteroids, DMARDs (slow progression), BRMs – Enbrel/etanercept
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| Psoriatic arthritis PT Goals | joint protection strategies, improve jt mechanics & CT function, aerobic conditioning
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| Chronic systemic DO with symmetrical dysfxn in synovial tissues and articular cartilage | Rheumatoid Arthritis
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| RA joints most effected | hands, wrists, elbows, shoulders, knees, ankles, feet
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| Hand characteristic sx in RA | pannus formation, ulnar drift, volar subluxation of MCP, swan neck deformity, boutonniere deformity, Bouchard’s nodes
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| Pannus | inflammatory granulation tissue on joint surface in RA
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| Bouchard’s nodes | excessive bone formation on dorsal PIP joints
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| RA incidence by sex | women 2-3x more likely
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| JRA | onset of RA prior to 16yr with complete remission in 75% of kids
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| RA Meds | gold compounds, DMARDs (hydroxychloroquine, methotrexate), NSAIDs, immunosuppressivess, corticosteroids
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| RA Dx tests | XR with symmetrical joint involvement, incr WBC & ESR, anemia, RF elevated
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