older adult: osteoarthritis

Deterioration and abrasion of joint cartilage with formation of new bone at the joint surfaces
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Deterioration and abrasion of joint cartilage with formation of new bone at the joint surfaces
osteoarthritis
risk factor?
growing older
cartilage destruction can begin between ages ?
20-30
bony enlargements may be present but generally does not affect?
function
etiology
- few patients experience symptoms until after age ?
50-60
etiology
- more than half >65 years have x-ray of disease in at least ?
1 joint
etiology
- before age 50, men are more affected than ?
- after age 50, incidence greater in ?
- women
- women
etiology
- predisposed factors?
Excessive use of joint, trauma, obesity, low vitamin D and C, and genetic factors
symptoms: joint pain
- worse with joint use
- early stage: __________ relieves pain
- later stage: pain with rest and sleep is ________________ because of pain and increased joint discomfort
- rest
- disturbed
symptoms
- becomes worse as barometric pressure ____________________
- joint stiffness occurs after periods at rest or _________________
- early morning stiffness resolves within?
- decreases
- static position
- 30min
*symptoms* - over activity can cause mild joint ____________, temporarily increasing stiffness - excessive ____________ will cause more destruction and pain- effusion - exerciseGrating sensation caused by loose particles of cartilage in joint cavityCrepitationOA affects joints?asymmetrically - ex: left hip but not in right hip*symptoms* - most commonly involved joints: joints of fingers?- Distal interphalangeal (DIP) - Proximal interphalangeal (PIP) - Metacarpophalangeal (MCP) joint*symptoms* - most commonly involved joints: weight bearing?hips, knees*symptoms* - most commonly involved joints: metatarsophalangeal ?joint of foot*symptoms* - most commonly involved joints: vertebrae?cervical and lumbar*symptoms: deformity (Heberden's (DIP joints) and Bouchard's node (PIP joints)* - red, swollen, tender - visible disfigurement --> can be _______________ - does not cause significant loss of ? - osteophyte formation and loss of ?- distressed - function - joint space*symptoms: deformity* - knee OA often leads to joint malalignment - result of cartilage loss in ? - ___________________ appearance - altered ?- medial compartment - bowlegged - gait*collaborative care* - no cure, care focuses on managing pain, inflammation, maintenance of functionality - rest and joint ___________________ during acute inflammation- protection*collaborative care* - functional positioning with ? - avoid increased stiffness by limiting immobility to less than ?- splints or braces - 1wk*collaborative care* - reduce ? - heat and cold application (heat stiffness, cold inflammation) - nutritional therapy and exercise - complementary therapy?- weight - glucosamine, chondroitinmeds are based on ______________ of symptoms.severitycommon meds?opioids, vitamins, NSAIDS*meds* - mild to mod pain?- Tylenol*mild to mod pain* - topical salicylates?Aspercreme*mild to mod pain* - OTC creams containing?camphor, eucalyptus oil, and menthol*mild to mod pain* - topical agent?capsaicin cream*meds* - mod to severe pain?- NSAID - Celebrex - corticosteroids*meds: mod to severe pain* - NSAIDS start __________________ - Ibuprofen 200mg up to ______________ a day - Misoprostol (cytotec) to decrease ___________________ - arthrotec (combo of misoprostol and diclofenac) - diclofenac gel- slow - 4x - GI effects*meds: mod to severe pain* - intraarticular corticosteroids - 4 or more injections without relief suggest new intervention. - do not give ?systemically