Osteoarthritis
What is OA?
Degeneration of joint cartilage which thins, creating bone spurs, decreased synovial fluid
What gene marker is associated with RA?
HLA-DR4
What is the most common type of MD?
Duchenne
What gender is this condition most common in?
Which bone cell is more active in Paget's Disease?
Osteoclasts - bone breakdown
Incidence increases with...
Age, obesity, previous joint injury, and repetitive use
What forms within the affected joint that destroys the cartilage?
Pannus
What patient population is most affected?
X-linked recessive disorder
What is the criteria for being diagnosed with fibromyalgia?
Widespread Pain (WPI) of 7 or higher with symptom severity of 5 or higher OR WPI of 3-6 and symptom severity 9 or higher
symptoms present for 3 months or longer
pain in 11/18 pain spots
What patient population is osteoporosis most common in?
Postmenopausal women
Where on the finger are Bouchard's nodes located?
PIP (proximal joints)
What is characteristic of Stage 4 of RA?
End stage, no longer considered a joint
-Ankylosis - bones fuse together, reduced muscle strength
What is Gower's Sign?
difficulty transitioning from sitting to standing position, move hands up thighs slowly for support
How many PAIRS of pain spots?
9
18 total
What lab value will be elevated in Paget's?
Serum alkaline phosphate (but calcium stays normal!)
What should you NOT do after applying topical cream such as capsicin or voltaren cream?
Apply heat
INCREASES risk for burns
What is the criteria for an RA diagnosis?
Pain lasting longer than 6 weeks, morning stiffness lasting over 60 minutes, and systemic symptoms
-ESR and CRP level will be elevated, Rheumatoid factor will be positive
What are symptoms of MD?
chronic pain in lower back and legs, muscle wasting, lordosis, waddling gait, pseduo-hypertrophy of muscles (especially calves), deterioration of facial muscles
What medications are given for this disorder?
Antidepressants, anticonvulsants, muscle relaxants, opioids
What is the recommended diet for osteoporosis?
Diet high in protein, calcium, Vit D (tums are good source of calcium - but high in sodium)
What do you look for during an exam for OA?
Pain, morning stiffness lasting longer than 30 minutes, reduced range of motion, joint malalignment (usually asymmetrical), crepitus
Radiological presence of bone spurs, joint space narrowing
What is the contraindication to gold compound injections for RA?
Cannot be pregnant
What medication promotes anti-inflammatory effects and slows muscle deterioration?
Gluccocorticoids
What is a good pain goal to shoot for?
4/10 and below - functioning level of pain, stable vital signs, keep a diary of triggers to maintain this goal
What is the gold standard diagnostic test for both disorders?
Bone mineral scan
-DEXA scan checks for osteopenia (bone loss)