joint disorders pt. 2

Question 1

juvenile idiopathic arthritis (JIA) symptoms/presentation

Answer 1

dull pain
aching
presents in morning/early in the day

Question 2

what time of day do growing pains occur

Answer 2

nighttime

Question 3

3 major classifications of juvenile idiopathic arthritis

Answer 3

pauciarticular (50%)
polyarticular (40%)
systemic-onset (10%)

Question 4

pauciarticular (oligoarticular) JIA presentation

Answer 4

relatively mild with few extraarticular features
swollen joint and limp in the morning
leg-length discrepancy
(girls > boys)

Question 5

polyarticular JIA presentation

Answer 5

5+ joints
symmetric presentation
destructive arthropathy
(girls > boys)

Question 6

Systemic-onset JIA (still disease) presentation

Answer 6

any # of joints
most severe extraarticular manifestations
intermittent high fever and chills
rash on thighs and chest that goes away after a few hours
(boys = girls)

Question 7

pauci-

Answer 7

having or involving few

Question 8

2 subtypes of polyarticular JIA

Answer 8

RF+
RF-

Question 9

polyarticular JIA RF+

Answer 9

has RF
subcutaneous nodules
cervical spine fusion
chronic uveitis
destructive hip disease

Question 10

polyarticular JIA RF-

Answer 10

no RF
joint involvement less severe than RF+
morning stiffness and fatigue
low-grade fever

Question 11

systemic-onset JIA can cause inflammation in which organs

Answer 11

liver
spleen
heart

Question 12

spondyloarthropathies (SpAs)

Answer 12

inflammation of the joints of the spine

Question 13

spondyloarthropathies (SpAs) presentation

Answer 13

chronic inflammation of axial skeleton and SI joint
asymmetric involvement
negative for RF
(males > females)

Question 14

which joints are inflammed in Ankylosing Spondylitis (4)

Answer 14

SI joints
apophyseal joints
costovertebral joints
intervertebral joints

Question 15

secondary symptoms of Ankylosing Spondylitis

Answer 15

fibrosis
calcification
ossification w/ fusion
resultant postural deformities
pain

Question 16

when does Ankylosing Spondylitis typically begin + are males/females more effected

Answer 16

15-30
(rarely after 40)

males 2-3x more than females

Question 17

slide 18

Question 18

slide 19

Question 19

Enthesitis

Answer 19

inflammation of the tendons, ligaments, and capsular attachments to bone

Question 20

enthesis is commonly found in people with ______

Answer 20

Ankylosing Spondylitis (AS)

Question 21

what disease is associated with having “bamboo spine”

Answer 21

Ankylosing Spondylitis (AS)

Question 22

biggest contraindicated PT modality for pts with Ankylosing Spondylitis

Answer 22

back manipulations

(you could break their spine)

Question 23

__________ is an indicator of decreased axial skeleton mobility

Answer 23

loss of chest wall excursion

(thoracic spine and CV/CS joint involvement in chest expansion)

Question 24

how would a person with Ankylosing Spondylitis walk in severe cases

Answer 24

locked in a rigid, upright position
no rotation
knee flexion to stay upright

Question 25

what disease is Ankylosing Spondylitis typically coupled with

Answer 25

IBS (fever, fatigue, loss of appetitie/weight --> these help differentiate AS from chronic LBP)

Question 26

idiopathic variant of OA

Answer 26

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Question 27

Diffuse Idiopathic Skeletal Hyperostosis (DISH) presentation

Answer 27

Ossification of ligaments, especially the longitudinal ligaments of the spine (most commonly in thoracic spine) causes stiffness and back pain (men>women)

Question 28

clinical manifestations of DISH in early/mod/extensive/advanced stages

Answer 28

early: asymptomatic mod: symptomatic, dull pain, stiff extensive: hyperostosis formation on anterior cervical spine, hoarseness, snoring, dysphagia advanced: limited ROM, abnormal posture, calcifications along spine

Question 29

chronic autoimmune disease that causes arthritis-related effects in several organs

Answer 29

Sjögren Syndrome

Question 30

structures Sjögren Syndrome attacks (5)

Answer 30

moisture-producing glands (mouth/eyes) joints lungs kidneys liver

Question 31

second most common autoimmune rheumatic disease

Answer 31

Sjögren Syndrome (women>men)

Question 32

hallmark signs of Sjögren Syndrome

Answer 32

dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia)

Question 33

A seronegative inflammatory joint disease that causes periarticular bone erosions and occasional significant joint destruction

Answer 33

Psoriatic Arthritis

Question 34

clinical manifestations of psoriatic arthritis

Answer 34

oligoarticular or polyarticular arthritis, most commonly in DIP joints

Question 35

Reiter syndrome clinical triad

Answer 35

arthritis, urethritis, and conjunctivitis

Question 36

AS vs psoriatic arthritis sacroiliitis pain differences

Answer 36

AS = bilateral PA = unilateral

Question 37

pitting of the nail beds are associated with which disease

Answer 37

psoratic arthritis

Question 38

onycholysis (separation of nail plate from nail bed beginning) is associated with which disease

Answer 38

reactive arthritis

Question 39

does reactive arthritis present symmetrically or asymmetrically? which joints?

Answer 39

ASYMMETRICALLY typically with large/med joints of lower extremity

Question 40

t/f: reactive arthritis occurs at the spot of infection

Answer 40

FALSE it occurs AWAY from the primary infection site

Question 41

what is the most common example of reactive arthritis

Answer 41

reiter syndrome

Question 42

which joint disorder is associated with the triad of symptoms (urethritis, conjunctivitis, and arthritis)

Answer 42

reiter syndrome

Question 43

where does gout typically appear on its first attack?

Answer 43

the first metatarsal/digit of the foot

Question 44

what substance is produced in excess by the body to cause gout

Answer 44

uric acid urate crystals form in joints/soft tissue/kidneys

Question 45

a diet rich in ____ can leave a person more susceptible to gout

Answer 45

purines ex: shellfish, trout, sardines, meat, asparagus, beans, peas, fructose food/drink

Question 46

neuroarthropathy

Answer 46

articular abnormality related to neurologic deficits

Question 47

early neuroarthropathy joint changes can look very similar to which joint disease?

Answer 47

OA