OA, RA, Ankylosing spondylosis

Question 1

5 steps of OA

Answer 1

1. &laquo_space;articular cartilage
2. Subarticular cyst formation and sclerosis
3. Remodelling and osteophyte formation
4. Synovial irritation
5. Capsular fibrosis

Question 2

OA management

Answer 2

• Pain reduction- NSAIDS, rest/activity mod, steroids??
• Reduce joint load- gait aid, weight loss, reduce stressful jt activity, shoe mod
• Increase mobility

Question 3

Stages of RA

Answer 3

1. Synovitis- prolonged inflam = jt laxity, still reversible if jt intact
2. Destruction = erosion of cartilage, synovium could contract and cause subluxation
3. Deformity

Question 4

RA clinical features

Answer 4

• Morning stiffness- gets better during day
• Usually symmetrical
• Small jt’s first
• Lack of well-being, fever, fatigue

Question 5

RA diagnosis

Answer 5

• Serum rheumatoid factor
• Symptoms > 6/52
• AM stiff > 30 min
• 3 joint areas

Question 6

RA Mx

Answer 6

• Control inflammation/synovitis
• Maintain joint ROM- Passive or assisted active
• Prevent deformity
• Isometric/dynamic strengthening
• Hydrotherapy
• Drug therapy- anti-inflams, anti-rheumatic drugs, biological therapy

Question 7

Ankylosing Spondylitis Pathophysiology

Answer 7

• Autoimmune disease
• Inflammatory arthritis affecting joints of spine- ^Sx
• Results in fusion and deformity = &laquo_space;mobility
• M:F 3:1; 15-45 y.o.

Question 8

Ankylosing Spondylitis clinical features

Answer 8

• LBP, alternating butt pain
• Insidious onset
• PM pain, AM stiff
• Pain improves with exercise
• Posture change
• Muscle spasms
• Pain on bone palpation

Question 9

Ankylosing Spondylitis Mx

Answer 9

• Pain, mobility, function
• Fatigue
• Peripheral jt movement
• Education/self-help
• Hydrotherapy
• Drug management
• Orthosis