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Arthritic Conditions

NPTE Musculoskeletal

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