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OA and RA
Scorebuilders 2010
| Question | Answer |
|---|---|
| Osteoarthritis primary effects weight bearing joints and the most commonly effected sites include? | Cervical spine (C5-C6), lumbar spine, hips, knees |
| Osteoarthritis is a degeneration of what type of cartilage?1)hyaline cartilage (articular cartilage) 2) elastic cartilage 3) fibrocartilage | articular cartilage |
| After the articular cartilage is degenerated is osteoarthritis, what type of bone is thickened? 1)trabecular bone 2) spongy bone 3)subchondral bone | subchondral bone |
| Osteoarthritis is diagnosed at what age in what population | After age 40, men more than women |
| What are the risk factors of osteoarthritis? | Trauma, repetitive micro trauma, obesity |
| What is the step by step pathogenesis of osteoarthritis? | 1)cartilage becomes soft and damaged 2)osteophytes form 3)subchondral bone thickens 4) synovitis is mild to moderate |
| What types of things would increase the pain in osteoarthritis? | Increased pain after exercise, increased pain with weather changes |
| How long would joint stiffness last in osteoarthritis? | Less than 15 minutes |
| What clinical findings with the joints would you find with osteoarthritis? | Pain present at the affected joint, localized to a few joints, joints enlarged,joint motion limited, joint crepitus, joint stiffness < 15 minutes, Bouchard’s nodes, Heberden’s nodes |
| What type of onset is found in osteoarthritis? | Gradual onset |
| What types of modalities can you use with patients with osteoarthritis? | Cold,heat,US, hydrotherapy,paraffin,TENS,NSAIDs |
| How can you reduce the wb on the effected joints effected by OA? | Patient education on energy conservation, body mechanics, joint protection techniques, Rest, splinting, assistive devices, weight loss |
| What types of exercises would you do for patients with osteoarthritis? | Isometric followed by gradual progression to isotonic exercise |
| Where do you find Heberden’s nodes and Bouchard’s nodes; in RA or OA? | OA |
| What is a hard or bony swelling that can develop in the DIP? | Herberden’s nodes |
| What is a hard or bony swelling that can develop in the PIP? | Bouchard’s nodes |
| Will orthopedic surgical intervention be effective in OA or RA? | OA because RA is more of a systemic disease |
| In what joints does RA start? | Onset may occur first at any joint but it is common to find it in the small joints of the hand,foot,wrist and ankle |
| What is rheumatoid arthritis and how common is it? | Systemic autoimmune disorder of unknown etiology that involves periods of exacerbation and remission; 1-2% of the American population |
| Which of the following structures in RA has a chronic inflammatory reaction?A) Articular cartilage B) synovial tissues C) capsule D)subchondral | B) synovial tissues |
| Who is more affected by RA and at what age does it start? | Women affected 3 times more than men, most common age of onset is between 30-50 years of age |
| What is the pathogenesis of RA? | 1)thickening of synovial membrane in affected joints 2) colonization of lymphocytes which synthesize the rheumatoid factor 3) subsequent erosion of cartilage and supporting structures |
| How long does morning stiffness last in joints effected by RA? | Greater than one hour |
| What clinical presentation will you find with joints effected by RA? | Symmetrical polyarthritis, Pain and tenderness of affected joints, morning stiffness > 1 hour, warm joints, redness at joints |
| What type of onset typically presents with RA? | Onset may be gradual or immediate |
| What particular deformity of the joints occurs in joints affected by RA? | Boutonniere deformity-DIP extension, PIP flexion, Swan neck deformity-DIF flexion, PIP hyperextension |
| What is a Boutonniere deformity? | DIP extension, PIP flexion |
| What is a Swan neck deformity? | DIP flexion, PIP hyperextension |
| What are the systemic characteristics associated with RA? | Decrease in appetite, malaise and increased fatigue |
| What types of modalities can be used on joints with RA? | Hydrotherapy, hot pack, paraffin, cold; AVOID deep heat |
| What type of therapy should be used with the acute stage of RA?A) Active ROM B) isometrics C) passive ROM D) joint mobilizations | passive ROM |
| What type of therapy should be used in the subacute stage of RA?A)Active ROM B) isometrics C) passive ROM D) joint mobilizations | Active ROM |
| In OA or RA is complete bed rest or regular rest periods indicated? | RA |
| In OA or RA should splinting and use of assistive devices be used? | Both OA and RA |
| What should the patient education be focused on in OA and RA patients? | Patient education on disease process, energy conservation,body mechanics, joint protection techniques |
| What is rheumatism? | Non specific term for medical problems effecting the joints and connective tissues |
| What are some conditions that present with rheumatism? | OA, RA,JRA, gout, systemic lupus erythematosus, ankylosisng spondylitis |
| What is rheumatism characterized by? | Inflammation, degeneration or metabolic derangement of the connective tissue, soreness, joint pain, stiffness of muscles |
| What does the PT exam consist of for a patient who has rheumatism? | Measurement of independence with functional activities, measurement of joint inflammation, measurement of joint ROM, determination of limiting factors including pain, weakness, and fatigue |
| What should you measure in the joints in a person with rheumatism? | Joint ROM and joint inflammation |
| What are the short term goals in a patient with rheumatism in the acute stage? | Alleviate pain,Decrease inflammation maintain strength and endurance to activity |
| What can you provide to help the patient with rheumatism in the acute stage to be safe with motion? | Provide splinting and/or assistive devices to increase safety |
| What would you want the patient with rheumatism be independent with as a long term goal? | Proper body mechanics, reduction of biomechanical stressors, exercise program |
| What things do you want your patient with rheumatism to maximize as part of their long term goal? | Functional mobility, endurance to tolerate ADL |
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mbutterfly
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