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68wm6 p2 Inf Dis Mus

Inflammatory Disorders of the Musculoskeletal System

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
Created by: Shanejqb