mod 4- arthritis and finger deformities

osteoarthritis

which kind of arthritis is also known as degenerative joint disease (DJD)?

OA

arthritis characterized by erosion of articular cartilage and a decrease in synovial fluid

DIP, PIP, CMC joints of UE (small joints most affected)

what joints does OA primarily affect?

RA

arthritis characterized by inflammatory changes of the joints, tendons, and their sheaths

RA

arthritis that involves the immune system attacking joints

RA

arthritis that is a chronic disease

inflammation, loss of flexibility, contractures

ways that soft tissue is affected by OA

osteophytes, loss of joint congruity

ways that bone tissue is affected by OA

RA

which arthritis presents with noticeable fatigue?

instability, subluxation, dislocation, inflammation

common joint issues of RA

16

age under which juvenile arthritis is diagnosed

loss of motion in prox. and distal radioulnar joints, flexion contracture, collateral ligament laxity, bursitis

effects of arthritis on the elbow joint

> 4 mm space between humerus and radius

what is the “drop sign”

radial deviation of wrist, ulnar deviation of fingers, finger deformities

effects of arthritis on the hand

RA

are hand deformities more common in OA or RA?

palmar subluxation, ulnar deviation of extensor and and sometimes flexor tendons

effects of arthritis on the MCP joints

synovitis causes collateral ligaments to shorten and the joint capsule to stretch

effects of arthritis on the proximal IP joints

lateral bands displace palmarly

how does arthritis cause a Boutonniere deformity?

lateral bands become stuck dorsally

how does arthritis cause a swan neck deformity?

extension, flexion, extension

the boutonniere deformity involves _____ of the MCP, _____ of the PIP, and _____ of the DIP

flexion, hyperextension, flexion

the swan neck deformity involves ____ of the MCP, _____ of the PIP, and _____ of the DIP

affected joints are CMC, MCP, IP

how is the thumb’s PIP joint affected by arthritis

depends on MCP and PIP joints

how to determine if DIP joint will be in flexion or hyperextension due to arthritis

decreases inflammation, prevents further deformity, rests and supports, improves function, aids in post-op rehab, immobilizies

indications for splinting? (name 3)

more force

result of smaller moment arm in UEO

more pressure

result of smaller surface area in UEO

shear

what kind of force needs to be considered for suspension in UEO? (shear, gravitational)

within 1 cm from apex of humeral epicondyle

distance of elbow orthosis joint from landmark to prevent it from migrating

resting hand splint

orthosis that positions the wrist and digits statically to align joints

10-20d extension, 5d ulnar deviation

wrist angle for resting hand splint

abducted, opposed

thumb position for resting hand splint

slight flexion

fingers position for resting hand splint

cock-up splint

other common name for wrist orthosis

ulnar deviation orthosis

orthosis that supports MCP joints and provides a radially directed force

ulnar deviation orthosis

what is this?

thumb spica splint

orthosis that provides support to the CMC and MCP joints for acute RA or OA

thumb spica splint

what is this?

IP splint

what is this?

radial and ulnar styloid, MCP and IP joints, any bony prominences

landmarks for a WHO

ML at styloids and MCP joints, circumference at wrist and MCP, wrist to fingertip, wrist to elbow

measurements to take for a WHFO