joint disorders 1

Question 1

chondrolysis

Answer 1

narrowed joint space due to rapid cartilage degeneration

(leads to loss of ROM)

Question 2

3 causes of chondrolysis degeneration

Answer 2

infection
trauma (like surgeries)
prolonged immobilization

Question 3

which joint does chondrolysis most commonly occur? which population is most susceptible?

Answer 3

HIP
slipped capital femoral epiphysis (SCFE)

adolescent females

Question 4

osteoarthritis

Answer 4

slow degenerative joint disease that breaks down cartilage, bone, then soft tissues + synovial fluid

Question 5

primary vs secondary OA

Answer 5

primary: unknown cause
secondary is caused by: trauma, infection, hemarthrosis, osteonecrosis, etc.

Question 6

what is the most common joint disease

Answer 6

osteoarthritis

Question 7

The development of OA is a risk factor for also developing….

Answer 7

cardiovascular disease

Question 8

biggest difference between OA and RA

Answer 8

OA typically shows sign in one joint while RA attacks symmetrically

Question 9

creptius

Answer 9

audible crackling or grating sensation produced when moving joint

Question 10

OA of the hand affects which 2 joints the most

Answer 10

DIP and PIP

Question 11

osteophyte

Answer 11

bone spur

Question 12

heberden nodes

Answer 12

OA affecting DIP

Question 13

bouchard nodes

Answer 13

OA affecting the PIP

Question 14

Kellgren and Lawrence grade 1

Answer 14

possible osteophytes
no joint space narrowing

Question 15

Kellgren and Lawrence grade 2

Answer 15

definite osteophytes
possible narrowing of joint space

Question 16

Kellgren and Lawrence grade 3

Answer 16

moderate multiple osteopytes
definite joint space narrowing
some sclerosis and possible deformity of bone ends

Question 17

Kellgren and Lawrence grade 4

Answer 17

large osteophytes
marked joint space narrowing
severe sclerosis and definite deformity of bone ends

Question 18

what PT techniques are beneficial for OA

Answer 18

maintaining joint mobility and ROM
Eccentric contractions
Closed chain strengthening

Question 19

characteristics of rheumatic disease

Answer 19

• can affect WHOLE BODY
• episodic (exacerbation and remission phases)

Question 20

second most prevalent form of arthritis

Answer 20

rheumatoid arthritis

Question 21

what 2 other autoimmune diseases is RA associated with

Answer 21

Graves disease
Hashimoto thyroiditis

Question 22

Rheumatoid factors

Answer 22

autoantibodies that react
with immunoglobulin antibodies found in the blood

Question 23

how does synovitis occur in RA (3 steps)

Answer 23

synovial lining increases –> WBC increases –> synovium becomes edematous

Question 24

pannus

Answer 24

destructive vascular granulation tissue

Question 25

synovium has 2 primary functions:

Answer 25

1. lubricating joint 2. provides nutrients to avascular articular cartilage

Question 26

in RA, elevated cytokines inhibit ______ and activate ______

Answer 26

bone formation osteoclasts

Question 27

ankylosis

Answer 27

adhesions and fibrous/bony fusion of the joint

Question 28

what happens to the tendons and ligaments in a joint with RA destruction

Answer 28

LAXITY

Question 29

swan neck deformity

Answer 29

hyperflexion of DIP hyperextension of PIP

Question 30

boutonniere deformity

Answer 30

hyperextension of DIP hyperflexion of PIP

Question 31

2 finger deformities common in RA

Answer 31

swan neck boutonniere

Question 32

the longer a person has RA, the higher likelihood they will have disease/degeneration of the ______

Answer 32

cervical spine

Question 33

why is upper cervical spine the most affected in RA

Answer 33

C0-C1 and C1-C2 articulations are PURELY SYNOVIAL

Question 34

what complication can occur with anterior subluxation of C1-C2

Answer 34

spinal cord compression (by the dens)

Question 35

where do RA cutaneous granulomatous lesions usually occur

Answer 35

areas of repeated mechanical pressure ex: elbow, achilles tendon, extensor surfaces of fingers

Question 36

nodulosis

Answer 36

subcutaneous nodules in RA

Question 37

what is the cause of compressive cervical myelopathy

Answer 37

laxity of the transverse ligament caused by RA

Question 38

how do peripheral neuropathies occur

Answer 38

nerves become compressed by inflamed synovia in tight compartments

Question 39

rheumatoid vasculitis involving medium-sized arteries can lead to

Answer 39

mononeuritis multiplex

Question 40

small vessel vasculitis

Answer 40

brown infarcts found on the palm and fingers of patients with RA

Question 41

most common surgery for RA in the hand

Answer 41

tenosynovectomy

Question 42

what joints typically affect patients with RA? Is it symmetrical or asymmetrical presentation?

Answer 42

small joints of feet and hands SYMMETRICALLY

Question 43

3 major signs of RA

Answer 43

1. symmetrically affected joints of the feet/hands 2. unexplained joint pain with SYSTEMIC SYMPTOMS (rash, nodules) 3. insidious onset of polyarthritis/joint pain after taking new meds or having an infectious disease

Question 44

age of OA vs RA

Answer 44

OA: 40+ RA: 25-50

Question 45

is C-reactive protein present in pts with OA or RA?

Answer 45

RA it is an indicator of systemic inflammation