OSTEOARTHRITIS RHEUMATOID ARTHRITIS
Bone-on-bone Thinned cartilage
Chronic, progressive disease of joints,
usually weight-bearing joints i.e. hips,
knees, vertebra. Goal = help maintain
mobility & ↓ pain. *Usually >65 yo*
Risks: Females, joint injuries,
occupations with repetitive stress on
joints (nurse), smoking, obesity
Signs & symptoms:
Pain, stiffness in AM or with exercise;
relieved after 30 min with rest
Swelling, tenderness, ↓ mobility
Bone spurs, bone-on-bone
Grating sensation when joints bend
Crepitus (air bubbles)
Herberden nodes (distal) & Bouchard
nodes (proximal; closer to you)
Asymmetrical; can affect any joint
Treatment:
-Acetaminophen
(Antidote: Acetylcysteine)
-Hyaluronic Acid; injection
-PT & OT
-Scooters, walkers, canes, splints, jar
openers, orthotic shoes
-If interventions don't work; total
joint arthroplasty (replacement)
Nursing:
-Home teaching: Use handrails, remove
throw rugs, keep common items in
reach
-LOW-IMPACT exercise i.e. swimming,
walking, biking to gain strength & ROM
-Avoid repetitive use of joints
-Balance active + rest periods
-Balanced nutrition & avoid obesity
Bone erosion Inflamed synovial membrane
Chronic, progressive autoimmune
disorder →body overreacting; attacking
→
peripheral joints inflamed joints →
remissions & exacerbations →life-long tx
Risks: Family hx, females, young to middle
age (affects younger people)
Signs & symptoms:
Morning stiffness & pain; improves
with movement
Bilat joint inflammation & ↓ROM
Warmth, redness, edema
Numbness, tingling of hands & feet
Late stages: Joint deformity
*Stress or recent illness causes
exacerbation/flare-up*
Treatment:
-NSAIDs: Ibuprofen, naproxen
-Prednisone
-Methotrexate
-Adalimumab
-PT & OT
Nursing:
-Enc. ice or heat for comfort
-Enc. physical activity to
maintain joint mobility
-Monitor for complications r/t
pharmacologic therapy