Rheumatoid Diseases Osteoarthritis Rheumatoid Arthritis Systemic Lupus Erythematosis Scleroderma Osteoarthritis Definition: *wear and tear, progressive, non-systemic, Degenerative Joint Disease (DJD) Pathophysiology Note top slide only
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Systemic Lupus Erythematosis
Note top slide only
Identify which joints are primarily affected with osteoarthritis.
What factors contribute to the development of osteoarthritis?
Structural changes with Osteoarthritis
Cartilage softens, pits, frays
Cartilage thinner, bone ends hypertrophy, bone spurs develop and fissures form
Secondary inflammation of synovial membrane; tissue and cartilage destruction; late ankylosis
What signs and symptoms does the person with osteoarthritis experience?
Normal Knee structure
Moderately advanced osteoarthritis
Onset of pain is insidious, individual is healthy!
Pain is aching in nature; relieved by rest!.
Local signs and symptoms: swelling, crepitation of joint and joint instability, asymmetrical joint involvement
Carpometacarpocarpal joint of thumb with subluxation of the first MCP
Late joint changes, boney sclerosis, spur formation
Synovial fluid inc., minimal inflammation
Interventions determined by complications
Medications (no systemic treatment with steroids)
Dietary to dec. wt.
Surgical Intervention (joint replacement)
Chronic systemic, inflammatory disease characterized by recurrent inflammation of diarthroidal joints and related structures.
*Body parts affected, systemic, small joints, symmetrical
Females, age 20-30; 3-1 ratio
Cause “wear and tear”, weight
Non-systemic, weight bearing joints
Middle-aged and elderly, males 2-1 affected
Fatigue, weakness, pain
IgG/RF (HLA)= antigen-antibody complex
Precipitates in synovial fluid
Granulation, inflammation at synovial membrane, invades joint, softens and destroys cartilage
Bilateral, symmetrical, PIP’s, MCP’s
Swan neck, boutonniere deformity
Pes plano valgus
Prominent metatarsal heads
Deformities that may occur with RA
Swan neck deformity
Mutlans deformity (rapidly progressing RA)
Subcutaneous nodules (disappear and appear without warning)
Joint Protection: Do’s and Don’t’s
SystemicLupus Erythematous (SLE)
Chronic multisystem disease involving vascular and connective tissue
Types: Discoid, SLE
Periods remission and exacerbation
Low grade fever
Characteristic butterfly rash associated with SLE, especially discoid lupus erythematous
SLE characterized by periods of remission and exacerbation. Stimulated by sunlight, stress, pregnancy, infections like strep and some drugs. Some drugs like apresoline, pronestyl, dilantin, tetracycline, phenobard may cause a lupus-like reaction which disappears when drug is stopped.
Criteria to Dx.
malar, discoid rash
Goal to control inflammation
Monitor/manage to prevent complications
Typical “hide-bound” face of person with scleroderma
Tissue hardens; claw-like fingers; fibrosis
More on CREST
R/O autoimmune disease
Radiological: pulmonary fibrosis, bone resorption, subcutaneous calcification, distal esophageal hypomotility
What are the KEY components of care for the individual with Scleroderma?
Definitions; polyarteritis of spine
Affects mostly men
Associated with HLA positive antigen
Signs and symptoms
Morning backache, flexion of spine, decreased chest expansion
Inflammation of spine; later spine ossification
Oh my back hurts!
Comparison of changes with ospeoporosis and Ankylosing spondylitis
Identify a PRIORITY nursing concern related to ankylosing spondylitis
Reactive arthritis associated with enteric disease
Caused by spirochete, borrelia burgdorferi
Inflammation, necrosis of walls small to medium sized arteries
Affects skin and voluntary muscles