Skeletal System Diseases and Disorders. Arthritis Rheumatoid Rheumatoid Osteoarthritis...

Skeletal SystemSkeletal System

DiseasesDiseases and Disordersand Disorders

ArthritisArthritis

RheumatoidRheumatoid

OsteoarthritisOsteoarthritis

Juvenile Rheumatoid ArthritisJuvenile Rheumatoid Arthritis

Rheumatoid ArthritisRheumatoid Arthritis

Chronic disease Chronic disease Joints become inflamed and painfulJoints become inflamed and painful Small joints of hands and feet Small joints of hands and feet

affected first and moves to larger affected first and moves to larger jointsjoints

More common in womenMore common in women ETIOLOGY – Thought to be ETIOLOGY – Thought to be

autoimmuneautoimmune

Rheumatoid ArthritisRheumatoid Arthritis

Diagnosed by blood test – Diagnosed by blood test – rheumatoid factor present ANDrheumatoid factor present AND

X-rays – boney changesX-rays – boney changes TX: Heat and medications to TX: Heat and medications to

reduce inflammation and painreduce inflammation and pain

Rheumatoid ArthritisRheumatoid Arthritis

Rheumatoid ArthritisRheumatoid Arthritis

OsteoarthritisOsteoarthritis

Chronic diseaseChronic disease Joints have loss of articular Joints have loss of articular

cartilage and hypertrophy of bone cartilage and hypertrophy of bone at articular surfacesat articular surfaces

Mainly in hips and knees of older Mainly in hips and knees of older peoplepeople

ETIOLOGY: Can be due to “old” ETIOLOGY: Can be due to “old” injuriesinjuries

OsteoarthritisOsteoarthritis

Tx: Medication to reduce pain Tx: Medication to reduce pain and inflammationand inflammation

Physical Therapy to loosen Physical Therapy to loosen impaired jointsimpaired joints

Most common reason for joint Most common reason for joint replacement surgeryreplacement surgery

Normal Knee Knee with Normal Knee Knee with OAOA

OsteoarthritisOsteoarthritis

OsteoarthritisOsteoarthritisNormal knee in figure 1Normal knee in figure 1

Narrow joint space and bone spur in figure 2Narrow joint space and bone spur in figure 2

Juvenile Rheumatoid Juvenile Rheumatoid ArthritisArthritis

Most common form of arthritis in Most common form of arthritis in children under age 16children under age 16

Joint pain, swelling, and stiffnessJoint pain, swelling, and stiffness Fever, rash, swollen lymph glandsFever, rash, swollen lymph glands Can cause growth problems and Can cause growth problems and

eye inflammationeye inflammation ETIOLOGY: AutoimmuneETIOLOGY: Autoimmune

Juvenile Rheumatoid Juvenile Rheumatoid ArthritisArthritis

TreatmentTreatment

Controlling painControlling pain

Improving functionImproving function

Preventing joint damagePreventing joint damage

JRAJRAKelly Rouba, a communications and emergency management specialist for the state of New Jersey, has been coping with JRA from a very young age, and her experiences inspired her to write the book Juvenile Arthritis: The Ultimate Teen Guide.

OsteomyelitisOsteomyelitis

Infection or inflammation of a Infection or inflammation of a bonebone

FeverFever Pain in area of infectionPain in area of infection Swelling, warmth and redness Swelling, warmth and redness

over area of infectionover area of infection

OsteomyelitisOsteomyelitis

ETIOLOGY: Most cases are caused ETIOLOGY: Most cases are caused by Staphylococcus bacteriaby Staphylococcus bacteria

Can enter through the Can enter through the bloodstreambloodstream

Nearby infection such as an Nearby infection such as an infected puncture woundinfected puncture wound

Direct contamination such as with Direct contamination such as with a compound fracture and surgeriesa compound fracture and surgeries

OsteomyelitisOsteomyelitis

TreatmentTreatment Antibiotics through IV for 4 to 6 Antibiotics through IV for 4 to 6

weeksweeks

Surgery to removed infected bone Surgery to removed infected bone

OsteomyelitisOsteomyelitis

Osteomyelitis of proximal phalanx of 4Osteomyelitis of proximal phalanx of 4thth digit.digit.

OsteoporosisOsteoporosis

New bone growth does not keep New bone growth does not keep up with old bone removalup with old bone removal

Bones become weak and brittleBones become weak and brittle Bending over or coughing can Bending over or coughing can

cause fracturecause fracture Hip, wrist and spine – most Hip, wrist and spine – most

common places of fracturecommon places of fracture

OsteoporosisOsteoporosis

SymptomsSymptoms Asymptomatic in early stagesAsymptomatic in early stages Back painBack pain Loss of heightLoss of height Stooped postureStooped posture Bone fractures occur more easily Bone fractures occur more easily

than expectedthan expected

OsteoporosisOsteoporosis

TreatmentTreatment BisphosphonatesBisphosphonates

Estrogen in post menopausal Estrogen in post menopausal women women

OsteoporosisOsteoporosisNormal Bone Osteoporotic Normal Bone Osteoporotic BoneBone

Carpal TunnelCarpal Tunnel

Compression of median nerve on Compression of median nerve on anterior side of wrist.anterior side of wrist.

Burning, tingling, and itching Burning, tingling, and itching numbness of palm, thumb, index numbness of palm, thumb, index and 3and 3rdrd fingers, and radial side of fingers, and radial side of the 4the 4thth finger finger

Carpal TunnelCarpal Tunnel

ETIOLOGYETIOLOGY Predisposition: Carpal tunnel Predisposition: Carpal tunnel

smaller in some peoplesmaller in some people Injury to wristInjury to wrist Repetitive movements of wristRepetitive movements of wrist Vibrating hand toolsVibrating hand tools IdiopathicIdiopathic

Carpal TunnelCarpal Tunnel

TreatmentTreatment Anti-inflammatory medicationsAnti-inflammatory medications Cortisone injection into carpal Cortisone injection into carpal

tunneltunnel Splints to immobilizeSplints to immobilize If above does not work, surgical If above does not work, surgical

release of carpal ligamentrelease of carpal ligament

Carpal TunnelCarpal Tunnel

Ankylosing SpondylitisAnkylosing Spondylitis

Inflammatory disease that can Inflammatory disease that can cause vertebrae to fusecause vertebrae to fuse

Can result in hunched forward Can result in hunched forward postureposture

Ankylosing SpondylitisAnkylosing Spondylitis

EtiologyEtiology

No known specific causeNo known specific cause

Appears to be geneticAppears to be genetic

Ankylosing SpondylitisAnkylosing Spondylitis

TreatmentTreatment Medication to reduce pain, Medication to reduce pain,

inflammation and stiffnessinflammation and stiffness

Physical Therapy for Physical Therapy for strengthening and flexibilitystrengthening and flexibility

Ankylosing SpondylitisAnkylosing Spondylitis

Progression of Ankylosing SpondylitisProgression of Ankylosing Spondylitis

ScoliosisScoliosis

Lateral curvature of the spineLateral curvature of the spine TreatmentTreatment

Bracing to prevent progressionBracing to prevent progression Surgery: fusion of vertebraeSurgery: fusion of vertebrae Harrington rods if child is still Harrington rods if child is still

growing.growing.– Rods can be lengthened every 6 Rods can be lengthened every 6

monthsmonths

Scoliosis-before/afterScoliosis-before/after

Kyphosis- humpbackKyphosis- humpbackoften due to often due to osteoporosisosteoporosis

Lordosis-swaybackLordosis-swayback