NURS 308 - Osteoarthritis, Rheumatoid Arthritis, Osteoporosis

osteoarthritis

slowly progressive non-inflammatory disease of the synovial joints

osteoarthritis

does not cause chronic inflammation of the joints - inflammation is only seen with synovitis

osteoarthritis

risk: aging

osteoarthritis

risk: obesity

osteoarthritis

risk: muscle weakness

osteoarthritis

affected by age 40 (usually older than 40)

osteoarthritis

crepitation with motion

osteoarthritis

joint stiffness after periods of rest lasting less than 30 min

osteoarthritis

heberden's & bouchard's nodules

osteoarthritis

only local manifestations

osteoarthritis

affects joints asymmetrically

osteoarthritis

priority: maintain & improve joint function

osteoarthritis

immobilization & splints for no more than one week (only use for acute synovitis)

osteoarthritis

no specific lab or biomarkers

osteoarthritis

weight-bearing joints of knees and hips, small joints (PIPs, MCPs, MTPs), cervical and lumbar spine

osteoarthritis

x-rays: joint space narrowing, osteophytes, subchondral cysts, sclerosis

osteoarthritis

what disease does this picture indicate?

rheumatoid arthritis

chronic, systemic, autoimmune, inflammatory disease involving mainly connective tissue of synovial joints

rheumatoid arthritis

characterized by flares and remissions

rheumatoid arthritis

risks: environmental triggers

rheumatoid arthritis

affected from 30-50 years (young to middle age)

rheumatoid arthritis

fatigue

rheumatoid arthritis

anorexia + weight loss

rheumatoid arthritis

joint stiffness after periods of rest lasting from 60 min to several hours

rheumatoid arthritis

fever

rheumatoid arthritis

cataracts & vision loss

rheumatoid arthritis

sjogren's syndrome

rheumatoid arthritis

muscle fiber degeneration

rheumatoid arthritis

peripheral neuropathy

rheumatoid arthritis

interstitial fibrous tissue

rheumatoid arthritis

felty's syndrome

rheumatoid arthritis

flexion contractures & hand deformities

rheumatoid arthritis

both local & systemic manifestations

rheumatoid arthritis

extra-articular manifestations

rheumatoid arthritis

affects joints symmetrically

rheumatoid arthritis

priority: prevent contractures

rheumatoid arthritis

priority: prevent infection

rheumatoid arthritis

immobilize the joints often with braces or splints to prevent contractures & deformities

rheumatoid arthritis

movement may worsen symptoms

rheumatoid arthritis

monitor: ↑ ESR - ↑ CRP

rheumatoid arthritis

monitor: RF - ANA - anti-CCP

rheumatoid arthritis

monitor: ↓ RBC - ↓ WBC - ↓ platelets

rheumatoid arthritis

high risk for infection

rheumatoid arthritis

small joints are typically affected first (PIPs, MCPs, MTPs); then wrists, elbows, shoulders, and knees

rheumatoid arthritis

x-rays: joint space narrowing and erosion with bony overgrowths, subluxation with advanced disease

rheumatoid arthritis

what disease does this picture indicate?

rheumatoid arthritis

what disease does this picture indicate?

osteoporosis

chronic, progressive metabolic bone disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility

osteoporosis

risk: ↓ body weight

osteoporosis

risk: white or asian

osteoporosis

risk: sedentary lifestyle

osteoporosis

risk: postmenopausal

osteoporosis

risk: diet ↓ in Ca or vitamin D

osteoporosis

risk: smoking

osteoporosis

risk: alcohol abuse

osteoporosis

risk: ↓ testosterone

osteoporosis

back pain

osteoporosis

spontaneous fractures

osteoporosis

loss of height

osteoporosis

dowager's hump or kyphosis

osteoporosis

eat foods high in calcium for prevention: milk, cheese, almonds, icecream, seafood, yogurt

osteoporosis

supplement vitamin D

osteoporosis

priority: safety

osteoporosis

monitor: calcium - phosphorus - alkaline phosphatase - vitamin D

osteoporosis

monitor: bone mineral density

osteoporosis

high risk for fractures

osteoporosis

what disease does this picture indicate?