Osfeoorfrifis Osfeoorfrifis Osfeoorfrifis Osfeoorfrifis

8y: 8y:
PizoIyn Dumonois PizoIyn Dumonois
Osteourthritis (Deqenerutive
Arthritis or Deqenerutive Joint
· If is fhe mosf common form of
orfhrifis.Derived from fhe 0reek
word "osfeo", meoninq "of fhe
bone", "orfhro", meoninq "¡oinf",
ond "ifis", meoninq infIommofion,
oIfhouqh fhe "ifis" of osfeo
orfhrifis is somewhof of o
misnomer¬infIommofion is nof o
conspicuous feofure.MefoboIic
disorder chorocferized by Ioss of
bone moss, increosed bone
froqiIify ond on increosed risk of
frocfure.Deqenerofion ond
proqressive soffeninq ond Ioss of
corfiIoqe Ieodinq fo formofion of
new bone of corfiIoqe Iininq.
· Primury osteourthritis - o normoI porf of
oqinq, resuIfs from mony fhinqs, incIudinq
mefoboIic, qenefic, chemicoI, ond
mechonicoI focfors
· Secondury osteourthritis - usuoIIy foIIows
on idenfifiobIe predisposinq evenf- mosf
commonIy froumo, conqenifoI deformify, or
obesify- ond Ieods fo deqenerofive chonqes
#isk Fuctors
· Siqns und Symptoms
· The most common symptom of osteourthritis
is u deep, uchinq |oint puin, purticuIurIy
ufter e×ercise or wuit beurinq, usuuIIy
reIieved by rest The symptoms incIude
· Achinq durinq chonqes in weofher
· Limifed movemenf.
· Poin oqqrovofed by use ond reIieved by resf.
· Decreosed POM, crepifus
· 8ourchord's- bony overqrowfh of fhe proximoI
inferphoIonqeoI ¡oinfs.
· SweIIinq
· In smoIIer ¡oinfs, such os of fhe finqers, hord bony
enIorqemenfs, coIIed Heberden´s nodes (on fhe disfoI
inferphoIonqeoI ¡oinfs) ond/or 8ouchord´s nodes (on fhe
proximoI inferphoIonqeoI ¡oinfs), moy form, ond fhouqh fhey
ore nof necessoriIy poinfuI, fhey do Iimif fhe movemenf of
fhe finqers siqnificonfIy. OA of fhe foes Ieods fo fhe
formofion of bunions, renderinq fhem red or swoIIen
Diuqnostic Procedures
· 8Iood fesf
· X-roys
· Arfhrocenfesis
· Arfhroscopy
· Treofmenf qeneroIIy invoIves o combinofion of exercise,
IifesfyIe modificofion ond onoIqesics. If poin becomes
debiIifofinq ¡oinf repIocemenf surqery moy be used fo
improve fhe quoIify of Iife.
· ArfhropIosfy: (porfioI or fofoI): repIocemenf of
deferiorofed porf of ¡oinf wifh prosfhefic oppIionce.
· OsfeopIosfy: scroppinq ond Iovoqe of deferiorofe bone from
· Osfeofomy: chonqe in oIiqnmenf of bone fo reIieve sfress by
excision of wedqe of bone or cuffinq of bone.
· Acefominophen: nonsferoidoI onfi-infIommofory druqs
(MSAIDs) if ¡oinf sympfoms persisf.
ursinq Munuqement/HeuIth
· If fhe pofienf needs surqery, provide oppropriofe preoperofive ond
posfoperofive core.
· Provide emofionoI supporf ond reossuronce fo heIp pofienf cope wifh Iimifed
· Assess ¡oinfs for poin ond POM.
· Encouroqe fo hove odequofe resf.
· Encouroqe osked for ossisfonce when movinq, ond encouroqe fo perform
· Teoch fhe pofienf fo ovoid overexerfion. He or She shouId foke fo sfond
ond woIk correcfIy, fo minimize weiqhf-beorinq ocfivifies, ond fo be
especioIIy corefuI when sfoppinq ond pickinq up ob¡ecfs.
· Advise fhe pofienf fo oIwoys weor weII-fiffinq supporfive shoes: don'f oIIow
fhe heeIs fo become foo worn down.
· TeII fhe pofienf fo insfoII sofefy devices of home, such os quord roiIs in fhe
· Insfrucf fhe pofienf fo foke medicofion exocfIy os prescribed, ond reporf
odverse reocfion immediofeIy
Gouty Arthritis (Gout)- a.k.a as podagra
Gout is condition that
resuIts from crystaIs of
uric acid depositing in
tissues of the body.
Gout is characterized
by an overIoad of uric
acid in the body and
recurring attacks of
joint infIammation
(arthritis). Uric acid is a
breakdown product of
purines that are part of
many foods we eat.
An abnormality in handling uric acid can cause attacks
of painful arthritis (gout attack), kidney stones, and
blockage of the kidney filtering tubules with uric acid
crystals, leading to kidney failure. Gout has the unique
distinction of being one of the most frequently recorded
medical illnesses throughout history. Gout is nine times
more common in men than in women. Ìt predominantly
attacks males after puberty, with a peak age of 75. Ìn
women, gout attacks usually occur after menopause.
Among the male population in the United States,
approximately 10% have elevated blood uric acid
levels, a condition known as hyperuricemia. However,
only a small portion of those with hyperuricemia will
actually develop gout. Ìf your parents have gout, then
you have a 20% chance of developing it
Hyperuricemia is the underlying cause of
gout. This can occur for a number of
reasons including dietary, genetic, or
underexcretion of urate, the salts of uric
acidAbout 10% of people with
hyperuricemia develop gout
#isk factors
Lead Exposures
excessive weight gain, especially in youth,
moderate to heavy alcohol intake, high blood
pressure, and
abnormal kidney function.
Certain drugs and diseases can also cause
elevated levels of uric acid.
$igns and $ymptoms
oint pain, redness, heat, swelling; great/big toe
and ankle are most commonly affected.
Headache, malaise, anorexia.
Tachycardia, fever, tophi Ìn the great toe, outer
ear, hands and feet.
idney stones
High Blood Pressure
Congestive Heart Failure
edicaI and $urgicaI anagements
Ìmmobilization and protection of the inflamed,
painful joints; local application of heat and cold.
Give analgesic to relieve pain
Continuity maintenance of allopurinol to control
uric acid level.
Ìn some cases, surgery may be necessary to
improve joint function or correct deformities,
tophi must be excised and drained if they
become infected or ulcerated
ursinq Munuqement/HeuIth
· Moinfoin o fIuid infoke of of Ieosf Z000 fo 3000mI. o doy fo ovoid
kidney sfones.
· Insfrucf cIienf fo ovoid oIcohoI ond coffeine. These producfs con
increose uric ocid IeveI.
· Avoid purine- rich foods (coffeine, oIcohoI, orqon meofs, sordines,
soImon, scoIIops ond qrovy).
· Insfrucf cIienf fo ovoid Iorqe doses of vifomin C whiIe fokinq
AIIupurinoI fo prevenf kidney sfones.
· Insfrucf cIienf fo foke druqs wifh food. fo prevenf 0I irrifofion.
· Advice cIienf fo hove yeorIy eye exominofion. VisuoI chonqes con
occur from proIonqed used of oIIopurinoI.
· Observe for fhe side effecfs of onfi qouf medicofions Iike
heodoche,nouseo, vomifinq, bone morrow depression skin rosh,
kidney sfone, mefoIIic fosfe
#heumatoid Arthritis
Ìt is a chronic, systemic inflammatory disorder that
may affect many tissues and organs, but
principally attacks synovial joints. Autoimmune
diseases are illnesses that occur when the body
tissues are mistakenly attacked by its own immune
system. Because it can affect multiple organs of
the body, rheumatoid arthritis is referred to as a
systemic illness and is sometimes called
rheumatoid disease. While rheumatoid arthritis is a
chronic illness, meaning it can last for years,
patients may experience long periods without
symptoms. Typically, however, rheumatoid arthritis
is a progressive illness that has the potential to
cause joint destruction and functional disability
The cause of rheumatoid arthritis is unknown.
Even though infectious agents such as viruses,
bacteria, and fungi have long been suspected,
none has been proven as the cause. The cause of
rheumatoid arthritis is a very active area of
worldwide research. Some scientists believe that
the tendency to develop rheumatoid arthritis may
be genetically inherited. Ìt is suspected that certain
infections or factors in the environment might
trigger the immune system to attack the body's
own tissues; resulting in inflammation in various
organs of the body such as the lungs or eyes.
Environmental factors also seem to play some role
in causing rheumatoid arthritis. Recently, scientists
have reported that smoking tobacco increases the
risk of developing rheumatoid arthritis.
#isk factors
Being Female: -Women are affected 2 to 3
times more than men.
Ages 40 to 60: -Ìt often begins at
Poor Diet and lifestyle: -Can hasten the
development of arthritis.
Environmental Factors
Genetic Predisposition: -May affect on how
the immune system functions causing
inflammation and eventual destruction of
the membranes that line the joints
$igns and $ymptoms
Fatigue, anorexia, malaise, weight loss, slight temperature
Painful, warm, swollen joint with limited motion, stiffness in
the morning and after periods of inactivity( non- use of
Cripping deformity in long standing disease.
Muscle weakness secondary to inactivity.
Some patients have other manifestations: subcutaneous
nodules, eye, vascular, lung or cardiac problems.
Sjogren's syndrome is characterized by:
Excessice dryness of the eyes, mouth and vagina.
Felty's syndrome is characterized by:
Luekopenia (causes low resistance to infection)
Splenomegaly (causes hemolutic anemia because trapped
RBC's in the spleen undergo hemolysis).
ursing anagement/ HeaIth
Encourage to do passive ROM exercises of
joints. To prevent contractures.
Apply splint painful joints.
Encourage to have adequate rest
Apply hot and cold compress
Warm bath in the morning. To relieve
morning stiffness.
Protect the client from infection.
Provide well balanced diet.
Encourage physical therapy as prescribed