arthritis and connective tissue dx
TRANSCRIPT
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7/30/2019 Arthritis and Connective Tissue Dx
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RTHRITIS & CONNECTIVE TISSUE DX:
A. ARTHRITIS- inflammation of joints, affects more womenB. OSTEOARTHRITIS- progressive, non-inflammatory, degenerative disorder affecting Dyarthroidal
(synovial) joint due to event that damages cartilage or of unknown cause
a. More prevalent women>50yrs- maybe due to lack of estrogenb. Damage sets off metabolic rx @ level chondrocytedull, yellow, soft, inelastic
cartilagebody attempts repairirregular bony growths
c. s/s: joint pain, stiffness during periods of rest & on waking (resolves 30min),crepetation, when affects phalanges HEBERDENs & BOUCHARDs NODEs, when
affects kneesbowlegged, when affects hip-one leg shorter
d. definitive dx=x-raye. Tx: rest & immobilization(1wk), application heat/cold, nutrition therapyreduce weight,
exercise, alternative therapy, drugs-acetaminophen, NSAIDS, antibiotics, intraarticular
injections of corticosteroids & hyaloronic acid, oral supps glucosamine & chondroitin
C. LOW BACK PAIN- caused by degenerative disk dx, herniated disk, lumbar-sacral strain,lumbar-sacral instability
a. Acute pain 3mths, weight reduction same as aboveD. LUMBAR DISK DAMAGE- can be degenerative or herniated disk (slipped). Most common s/s
low back pain, radicular pain down buttocks, & below knee, +ive straight leg test
a. Tx= conservative therapy- limit movement (brace, corsette, belt), ice/heat, ultrasoundmassage, traction, TENS, NSAIDS & muscle relaxants. Once symptoms subside, back
exercises 2xs dy for life
i. *can lose bowel or bladder control if worsensii.
Tx2= laminectomy Assess neurologic fxn & VS q4hrs 1st 24 Check ability void Log roll pt if prescribed bed rest Ensure brace worn when out of bed
E. RHEUMATOID ARTHRITIS- inflammation dx affecting connective tissues synovial joints.Periods exacerbation & remission. Cause=UNKNOWN
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a. s/s-fatigue, weight loss, anorexia, generalized stiffness, limitation motion, joint stiffnesson waking lasts >60min or hrs, joint pain that is warm to touch & increases with
motion, tenosynovitis & joint capsule deformity
b. Diagnosticsi. +RF, increased ESR & C-reactive protein, increased WBC (up to 25,000/uL),
fibrin flex in CSF, confirmed via tissue boipsy arthocentesis...bone scan helps
confirm
c. Tx: DMARDS- Sulfasalazine (alzulfidine, salazopyrin) &* Methotrexate (Rheumatrex)*,NSAIDS, biologic response modifiers, physical therapy, occupational therapy
F. GOUT- systemic dx in which Urate crystals deposit into joints7 tissues causing inflammationa. Cause=excess production uric acid, decreased secretion, increased ingestion purinesb. s/s: dusky, cyanotic joint, inflamed great toe, severe pain, trophy (visible uric acid
deposits), kidney stones
c. Diagnostics- increased uric acid, in serum & urined. Tx: colchine (novocoline, colsalide), NSAIDS, allopurinol (zyloprim)for chronic gout
i. Avoid aspirin, consume low-purine diet (avoid organ & red meats, shellfish, oilyfish), diuretics, excessive physical & emotional stress, drink plenty of fluids esp.
Milk, water & citrus juices
G. SYSTEMIC LUPUS ERYTHEMATOSUS- chronic autoimmune inflammatory dx affectsconnective tissues by the formation of immune complexes which deposit into the tissues &
blood vessels depriving tissue of O2.
a. Cause=unknownb. s/s: butterfly rash face or upper bodyteach avoid sun, excessive fatigue, formation
antibodies against blood cellsanemia, deceased WBC & decreased platelets
c. diagnosticsi. +iv blood presence ANA(antinuclear antibodies), RF, increased ESR, anti-SS-
A (R), anti-SS-B (La), anti-Smith (anti-SM0, anti-DNA & ENA (extractable
nuclear antigens)
ii. Chest x-ray, urinalysis, CBC, ECGiii. Tx: NSAIDS, Hydroxychloroquine (Plaquenil) to decrease inflammatory
response, teach monitor for fever (1st sign exacerbation), joint protection,
counsel against pregnancy.