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osteoarthritis (OA)
- the most common form of joint disease, its a slowly progressive noninflammatory disorder of the synovial joints.
- Cartilage destruction
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Diff btw OA & RA
systemic manifestations such as fatigue, fever and organ involvement are not present in OA.
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Crepitation
a granting sensation caused by loose particles of cartilage in the joint cavity, can also contribute to stiffness. Indicates loss of cartilage integrity & is present in more than 90% of pts with knee OA.
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Orteoarthritis (Joints)
Sitting down becomes difficult, as does rising from a chair when hips are lower than the knee. Early morning stiffness is common bt generally resolves within 30 mins.
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Osteoarthritis (Heberden nodes, Bouchards nodes)
- (DIP)distal interphalangeal
- (PIP)proximal interphalangeal
- (MCP)metacarpopalangeal
- (MTP)metatarsophalangeal
- deformity or instability associated with OA is specific to the involved joint.
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Synovial fluid
analysis allows differentiation btw OA and other forms of inflammatory arthritis. In the presence of OA, the fluid remains clear yellow with little or no sign of inflammation.
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Glucosamine
Use caution in pts with diabetes, and pts with shellfish allergies, renal disease or peptic ulcer. Contraindicted during pregnancy & lactating.
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Gerontologic Consideration
the older adult who takes NSAIDs has an increased risk for side effects, particularly GI bleeding and renal toxicity.
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Spondyloarthrothies
are a group of interrelated multisstem inflammatory disorders that affect the spine, peripheral joints, and periarticular stuctures.
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Ankylosing Spondylitis
is a chronic inflammatory disease that rimarily affects the axial skeleton, including the sacroiliac joints, intervertebral disk spaces, and costovertebral articulaitons.
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Psoriatic Arthritis
a common bening, inflammatory skin disorder that appears to have a genentic predisposition. PsA in now recognized as a progressive inflammatory disease that can cause signigicant disability.
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Azulfidine (sulfasalazine)
Therapeutic effect: reduction in the symptoms of inflammatory bowel disease. Used for Ankylosing Spondylitis and Psoriatic Arthritis
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HLA-B27
- HLA-B27 is a blood test to look for a protein that is found on the surface of white blood cells. The protein is called human leukocyte antigen B27 (HLA-B27).
- Human leukocyte antigens (HLAs) are proteins that help the body's immune system tell the difference between its own cells and foreign, harmful substances.
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Reactive Arthritis (Reiter's syndrome)
appeart to occur after a genitourinary o GI tract infection. Clamydia trachomatis is most often inplicated in sexually transmitted reactive arthritis.
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Septic Arthritis
is caused by invasion of the joint cavity with microorganisms. Large joints such as the knee and hip are the most frequently involved.
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Lyme disease
transmitted by the bite of an infected deer tick. Doxycycline has alos shown to be effective in preventing Lyme disease when given within 3days after the bite of a deer tick.
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