Term
| Rheumatoid Arthritis (description, etiology, symptoms, common types of deformities) |
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Definition
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description: systemic, symmetrical attack of many joints; characterized by remission and exacerbations
most commonly attacks hand joints
etiology: unknown, but two main theories: infection vs. autoimmune
symptoms: pain, stiffness, limited ROM, fatigue, weight loss, limited ADLs, swelling, deformities
common types of deformities: ulnar deviation and subluxation of the wrists and MCPs, boutonniere deformity, swan neck deformity |
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Term
| Boutonniere deformity (description) |
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Definition
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description: flexion of PIP and hyperextension of DIP |
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Term
| Swan neck deformity (description) |
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Definition
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description: hyperextension of PIP and flexion of DIP |
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Term
| Osteoarthritis (description, etiology, symptoms, types of bone spurs) |
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Definition
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description: degenerative joint disease (not systemic but wear and tear), commonly affects large weight bearing joints, attacks hyaline cartilage
etiology: genetic, trauma, inflammation, cumulative trauma, endocrine and metabolic disease
symptoms: pain, stiffness, limited ROM, bone spurs
types of bone spurs: Herberden's nodes at DIPs, Bouchard's nodes at PIPs |
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Term
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Definition
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Term
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Definition
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Term
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Definition
role requirements and expectations
ROM (focus on AROM)
muscle strength (avoid MMT unless specified by MD)
grip strength
ADLs and role activities
pain
edema |
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Term
| Arthritis' splinting (acute stage) |
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Definition
acute stage: resting hand splints
wrist splint (if arthritis specific to wrist)
ulnar drift splint to prevent deformity
silver ring splints to prevent boutonniere and swan neck deformities
dynamic MCP extension splint with radial pull for post-op MCP arthroplasties
hand base thumb splint for CMC arthritis |
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Term
| Arthritis' OT interventions |
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Definition
joint protection techniques
energy conservation techniques
ROM (focus on AROM, gentle PROM if AROM not possible)
heat modalities (hot packs before exercise, paraffin for hands)
strengthening (avoid during inflammatory stage, gentle strengthening while avoiding positions of deformity)
ADLs and role activities (joint protection, energy conservation techniques, adaptive equipment to prevent deformity, decrease stress on small joints, extend reach) |
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