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Arthritic conditions - Systemic vs. Non-systemic
- Systemic - Gout; RA; Psoaritic arthritis;
- Non-systemic - DJD (OA)
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Arthritic conditions - Bilateral vs. Typically Unilateral
- B/L - RA; Juvenile RA
- U/L - DJD (OA)
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DJD (OA) - Pain - 4
- Pain/stiffness upon rising
- Pain eases through morning (4-5 hrs)
- INC w/repetitive bending
- Described as sore, nagging
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DJD (OA) - Lab test - 1
- Erythrocyte sedimentation rate (ESR) - should be NORMAL
- Normal ESR - Male <15/Female <20
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DJD (OA) - Plain film findings - 3
- DEC joint space
- DEC height of articular cartilage
- Osteophytes
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OA - Hand - chief complaint - 1
Heberden's nodes - Painful, nodular swelling of DIPs
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Rheumatic Conditions - 5
- Ankylosing Spondylitis
- Gout
- Psoaritic Arthritis
- Rheumatoid Arthritis (RA)
- Juvenile RA
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Systemic symptoms - 4
- Fever/Chills
- Night Sweats
- Multi-Joint pain
- Minimally affected by pain relievers
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Ankylosing Spondylitis - define; onset; look; what movement is impaired? special test; mattress
- Progressive inflammatory disorder - initially affects axial skeleton before 40
- Onset - insidious/non-trauma
- INC stiffness/pain - caudal to cranial
- Impaired spinal EXTENSION
- "Bamboo spine" look
- Special test - Wright-Schober test for spinal mobility
- Mattress - FIRM
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Ankylosing Spondylitis - S/S - Late signs - 3
- Lumbar spine flattens
- Spinal kyphosis
- Sacroiliitis
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Ankylosing Spondylitis - Pulmonary/Why - 2
- Impaired chest mobility
- DEC vital capacity
- Degeneration of costovertebral jts
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Ankylosing Spondylitis - PT - contraindicated - 2
- High impact exercises
- Flexion exercises
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Gout - S/S - 5
- Intense jt pain at night - @ feet, especially big toe, ankle, mid foot
- Warmth
- Erythema
- Extreme tenderness, hypersensitivity
- Test - INC uric acid
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Psoriatic arthritis - definition
- SYSTEMIC arthritis
- Chronic, erosive inflammatory disorder associated w/psoriasis
- @ joints of digits & axial skeleton
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Psoriatic arthritis - S/S - 4
- Painful, swollen fingers & toes
- Achilles tendinitis
- Plantar fasciitis
- Spondylitis
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RA - S/S - 7
- SYSTEMIC = Fatigue; Low-grade fever
- B/L INVOLVEMENT - smaller peripheral jts affected 1st - wrist, MP, PIP
- Pain, swelling, redness in joints
- Stiffness (PROLONGED IN AM)
- Exacerbations & remissions
- Deformities (eg: swan neck, ulnar drift of MCPs, boutonniere)
- Tendon sheath inflammation
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RA - Articular S/S - Overall (1); Specific (3)
- Pannus formation (inflammation granulation tissue covering jt surface)
- Swan neck deformities
- Buttoner deformities
- Bouchard’s nodes (excessive bone on dorsal PIP)
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RA - Extra-articular complication - 1
Vasculitis
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RA - non-MSK S/S - 4
- Anemia
- Pericarditis
- Osteoporosis
- Eye lesions
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RA - C-spine - why involved? - 3
Erosion of dens, facets & transverse ligaments
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RA - special tests - 4
- RA factor
- ESR
- Radiography
- Bunnell-Littler
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Rheumatoid Arthritis - PT - 3
- Parafin wax
- PROM/AAROM within limits of pain
- Gentle isometrics in pain-free positions
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Rheumatoid Arthritis - PT contraindications - 3
- Resistance exercises
- Deep heating modalities
- Any form of active stretching (esp of swollen joints)
- AGGRESSIVE STRETCHING IS ALWAYS A NO
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Juvenile RA - S/S - 5
- Fever & rash
- Fatigue
- Weight loss
- Weakness
- General defuse MSK pain
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Juvenile RA - What happens to pain after periods of rest
Intense jt pain & stiffness lasting 30 MIN - SEVERAL HRS w/initiation of activities
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Juvenile RA - (+) test findings - 4
- INC WBC count
- INC ESR - inflammation
- INC Rheumatoid factor
- Anemia - DEC Hemoglobin & hematocrit
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Juvenile RA - 3
- Fever & rash; Fatigue; Weight loss; weakness
- Pain INC after rest
- Intense jt pain/stiffness lasting 30 MIN-SEVERAL HRS w/initiation of activities
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