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22 important questions on Rest/ctivity

Legg-Calve-Perthes Disease manifestations

Mild pain in hip, knee, and anterior thigh. Limp is painful. Relieved by rest. Later on muscle wasting, possible shortening of the affected limb and weakness

Slipped Capital Femoral Epiphysis (SPFE)

At times of rapid growth(puberty) that spontaneously displaces the proximal femoral epiphysis(plate) in a posterior or inferior direction due to the thinning of the plate because of hormonal influences. Also the increased body weight and height which causes stretching of the blood vessels

SPFE clinical manifestations

Limp and pain
Decreased range of motion
May also have pain in the groin, thigh or knee area
Leg may be turned outward to relieve stress and pain in hip

Scoliosis age groups

Congenital-fetal
Infantile- birth to 3 years
Juvenile- 3-10 years
Adolescents- >10 years old *usually picked up then

Ankylosing Spondylitis Tx

Keep spine flat, exercise, heat, hydrotherapy, NSAIDs, aspirin, DMARDS not much of an effect

Psoriatic Arthritis Dx

Xray-shows bones like a pencil in a cup.
Labs
Hyperuricemia-uric acid in the urine
HLA-B27-80%
Mild anemia can resemble RA

Psoriatic Arthritis Tx

Splinting (in functioning postion)
Joint protection
PT
Meds- NSAIDS, TNF inhibitors

Reactive Arthritis/Reiter's syndrome

Self limiting(can't go past a certain point) associated with arthritis, urethritis, conjunctivitis, and mucocutaneous lesions.

Reactive Arthritis Manifestations

Asymmetric, Weight bearing joints, Achilles tendonitis, Arthralgias(joint pain)

Reactive Arthritis Tx

NSAIDS, Antibiotics, DMARDS, and PT
Some have complete remission, some continue to have chronic problems

Systemic Lupus/Erythematosus

Inflammation of skin. Accumulation of circulating immune complexes that damage organs. Likely in women due to estrogen. 20-40 YO(child bearing age), Blacks and asians, certain NA tribes. Affects Skin, heart, blood, muscles, joints, kidneys, lungs

SLE drug induced

Drugs include
Anti-seizures
hydrolazine
Pronestol

SLE lab tests

Decreased RBC's
Normal platelet count 150-400,000 will be decreased
Pinpoint red or large patches or signs of blood
Heavy menstrual period, blood in stool report!
Normal hemoglobin- Males 14-18, females 12-16
WBC should be 6-9000
Postive Antinuclear antibodies 97%
Elevated ESR & gamma globulin
Anti-Smith(Sm) antibodies-30-40%
Creatinine may be increased

SLE triggers (an episode)

Sunlight, infection, injury, surgery, stress, overexertion, nervous tension, anxiety, emotional upsets, drug or illness

P/D S&S

Mild arthritis, Raynauld's, muscle atrophy, renal changes
*Cotton wool patches(retina) Aspiration pneumonia, weight loss, fatigue

P/D Dx

MRI, EMG(strong muscle involvement), Increased serum muscle enzymes, Elevated ESR & CCRP, muscle biopsy, positive RF. Muscles become so weak they can't raise their head off their pillow or stand from a chair.

P/D Tx

Corticosteroids(high doses), Immunosuppressive(cytoxan)
Bed rest for acute phase, assist with ADLS,

P/D Corticosteroids

High doses can cause weight gain, increased blood sugar, infection, osteoporosis in bones, oral ulcers, very hard on GI tract, but need to get muscle strength back

Myofascial pain Syndrome

Chronic form of muscle pain w/taut bands and fascia of skeletal muscles(TMJ)
Examples-Fibromyalgia, myalgia, myositis

Myofascial pain syndrome Tx

Spray and stretch-Spray coolant then stretch
One region usually affected, chest, neck, hips, back

Chronic Fatigue Syndrome

Difficult to distinguish between Fibromyalgia. Women are more affected.
Immune system is decreased, cognitive dysfunction, extreme exhaustion, sore throat, joint pain, severe headaches

Chronic Fatigue Syndrome Tx

Antihistmines-usually accompanied by allergies
Decongestant-" " by sinusitis
Antioxidants-dark colored, fresh fruits and vegetables
High activity exacerbates symptoms
Low activity increases depression and decreases motivation
SSRI(prozac)-can improve mood and sleep
Klonopin-sleep disorders and panic disorders
Hydrocortisone-help with fatigue??

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Rest/ctivity Test 2

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Rest/ctivity

22 important questions on Rest/ctivity

Legg-Calve-Perthes Disease manifestations

Slipped Capital Femoral Epiphysis (SPFE)

SPFE clinical manifestations

Scoliosis age groups

Ankylosing Spondylitis Tx

Psoriatic Arthritis Dx

Psoriatic Arthritis Tx

Reactive Arthritis/Reiter's syndrome

Reactive Arthritis Manifestations

Reactive Arthritis Tx

Systemic Lupus/Erythematosus

SLE drug induced

SLE lab tests

SLE triggers (an episode)

P/D S&S

P/D Dx

P/D Tx

P/D Corticosteroids

Myofascial pain Syndrome

Myofascial pain syndrome Tx

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome Tx

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