Create An Outline Of Chapter 24 Rheumatic Disorders ✓ Solved

Create an outline of Chapter 24 Rheumatic Disorders in the M

Create an outline of Chapter 24 Rheumatic Disorders in the Manske textbook. Include all diagnoses in the chapter. Follow the formatting below:

1. Osteoarthritis

a. Most common form of arthritis

b. Causes

i. Biomechanical, Metabolic, and Genetic

Paper For Above Instructions

This document provides a structured, chapter-style outline of Chapter 24: Rheumatic Disorders, suitable for use with the Manske Orthopedic Conditions & Rehabilitation text. The outline lists the common rheumatic diagnoses typically covered in a comprehensive orthopedic rehabilitation chapter, and for each diagnosis provides concise epidemiology, pathophysiology/causes, clinical features, diagnostic evaluation, treatment principles, and specific rehabilitation considerations. The presentation follows the requested hierarchical formatting and includes diagnoses commonly addressed in musculoskeletal and rheumatologic rehabilitation (Manske, 2015).

1. Osteoarthritis

a. Most common form of arthritis (Hochberg et al., 2012)

b. Causes

i. Biomechanical: joint overuse, malalignment, repetitive loading

ii. Metabolic: obesity, metabolic syndrome contributing to cartilage degeneration

iii. Genetic: family history and genetic predisposition

c. Clinical features: progressive joint pain, stiffness (worse after use), crepitus, limited range of motion

d. Evaluation: clinical exam, weight-bearing radiographs, consider MRI for soft-tissue or early cartilage changes

e. Treatment: activity modification, weight loss, NSAIDs, intra-articular injections, joint replacement for advanced disease (Hochberg et al., 2012)

f. Rehabilitation: joint protection strategies, progressive therapeutic exercise, neuromuscular training, gait training and pre/postoperative rehab for arthroplasty (Manske, 2015).

2. Rheumatoid Arthritis

a. Autoimmune inflammatory polyarthritis affecting synovium (Aletaha et al., 2010)

b. Causes: immune dysregulation with genetic (HLA-DRB1) and environmental triggers

c. Clinical features: symmetrical joint swelling, prolonged morning stiffness, systemic features

d. Evaluation: serology (RF, anti-CCP), inflammatory markers, imaging (ultrasound/MRI for synovitis)

e. Treatment: DMARDs, biologics, corticosteroids; early aggressive therapy to prevent joint damage (Kelley & Firestein, 2013)

f. Rehabilitation: preservation of joint function, energy conservation, splinting, ROM and strengthening adapted to inflammation level.

3. Juvenile Idiopathic Arthritis (JIA)

a. Pediatric onset inflammatory arthritis with several subtypes

b. Causes: immune-mediated with variable systemic involvement

c. Rehab focus: growth and development, school participation, adaptive devices, family education (Kelley & Firestein, 2013).

4. Ankylosing Spondylitis and Spondyloarthropathies

a. Axial skeletal involvement, enthesitis, HLA-B27 association (Braun & Sieper, 2007)

b. Clinical: inflammatory back pain, reduced spinal mobility, possible peripheral arthritis and uveitis

c. Management: NSAIDs, TNF inhibitors for refractory disease; emphasis on posture, spinal mobility exercises, respiratory expansion exercises in rehab.

5. Psoriatic Arthritis

a. Inflammatory arthritis associated with psoriasis, variable patterns (oligoarticular, polyarticular, DIP predominant)

b. Rehab goals: maintain joint function, address nail/skin issues impacting therapy, coordinate with dermatology and rheumatology.

6. Reactive Arthritis

a. Post-infectious asymmetric oligoarthritis often involving lower limbs and sacroiliac joints

b. Rehab: restoring mobility, addressing enthesitis-related pain, functional training during convalescence.

7. Crystal Arthropathies: Gout and CPPD (Pseudogout)

a. Gout: monosodium urate crystals, episodic inflammatory arthritis; risk factors include hyperuricemia, diet, and comorbidities (Chhana & Dalbeth, 2015)

b. CPPD: calcium pyrophosphate deposition causing pseudogout and chronic arthropathy (Dalbeth et al., 2016)

c. Evaluation: synovial fluid aspiration for crystal analysis, serum uric acid (gout)

d. Treatment: acute anti-inflammatory therapy, long-term urate-lowering for gout, joint-specific rehab during and after flares.

8. Systemic Lupus Erythematosus (SLE)

a. Multisystem autoimmune connective tissue disease with musculoskeletal manifestations (Tsokos, 2011)

b. Clinical: inflammatory arthralgias/arthritis, myalgias, tenosynovitis, sometimes erosive disease

c. Rehab: fatigue management, aerobic and strengthening programs adapted to disease activity, attention to organ involvement (renal, cardiac).

9. Systemic Sclerosis (Scleroderma)

a. Fibrosis of skin and internal organs, with joint stiffness and tendon friction rubs

b. Rehabilitation emphasis: hand function, scar and soft-tissue mobilization, ROM, airway and swallowing considerations when indicated.

10. Polymyositis and Dermatomyositis

a. Inflammatory myopathies causing proximal muscle weakness and functional limitations

b. Diagnosis: elevated CK, EMG, muscle biopsy, characteristic skin findings in dermatomyositis

c. Rehab: graded strengthening, aerobic conditioning, fall prevention, collaboration with medical therapy (immunosuppression).

11. Fibromyalgia

a. Centralized pain syndrome with widespread pain, fatigue, sleep disturbance, cognitive symptoms (CDC/NIH summaries)

b. Management: multidisciplinary approach with graded exercise, cognitive-behavioral strategies, sleep hygiene, and pain management; avoid excessive passive modalities that reinforce inactivity.

12. Polymyalgia Rheumatica and Giant Cell Arteritis

a. PMR: proximal pain and stiffness with elevated inflammatory markers; GC arteritis: potential vision-threatening vasculitis

b. Rehab: early mobilization, posture and ROM, close coordination with rheumatology and urgent medical care for vasculitis.

13. Vasculitides with Musculoskeletal Manifestations

a. Small-, medium-, and large-vessel vasculitides that may present with arthralgia, myalgia, and weakness

b. Rehabilitation tailored to organ involvement, exercise tolerance, and neuropathic complications.

14. Septic Arthritis (Differential Consideration)

a. Acute bacterial infection of joint—orthopedic emergency that mimics inflammatory arthropathies

b. Importance of early recognition, drainage, antibiotics, and post-infectious rehabilitation for residual stiffness.

Rehabilitation Principles Across Rheumatic Disorders

- Patient-centered assessment including functional goals, activity limitations, and psychosocial factors (Manske, 2015).

- Tailored exercise prescription: preserve ROM, strengthen periarticular muscles, improve endurance and balance (Hochberg et al., 2012).

- Pain management: pharmacologic coordination with rheumatology and non-pharmacologic modalities such as TENS, pacing, and CBT for chronic pain (Kelley & Firestein, 2013).

- Assistive devices, orthoses, adaptive equipment, and workplace/school ergonomic interventions to preserve participation.

- Prehabilitation and postoperative rehabilitation for arthroplasty and tendon or joint reconstructive procedures.

- Multidisciplinary coordination: physical therapists, occupational therapists, rheumatologists, orthopedists, and primary care for optimal outcomes (Manske, 2015).

Summary

This outline includes the primary rheumatic diagnoses generally addressed in an orthopedic rehabilitation textbook chapter and provides the core elements clinicians need: causes/pathophysiology, clinical presentation, diagnostic approach, medical management highlights, and rehabilitation considerations. Use this outline as a skeleton for deeper study, clinical note templates, or patient education modules; always reference current guidelines and collaborate with rheumatology for disease-modifying treatments (Aletaha et al., 2010; Hochberg et al., 2012).

References

  • Manske, R. C. (2015). Orthopedic Conditions & Rehabilitation. SLACK Incorporated.
  • Hochberg, M. C., Altman, R. D., April, K. T., Benkhalti, M., Guyatt, G., McGowan, J., ... & Tugwell, P. (2012). American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 64(4), 465-474.
  • Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., ... & Hawker, G. (2010). 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis & Rheumatism, 62(9), 2569-2581.
  • Kelley, W. N., & Firestein, G. S. (Eds.). (2013). Kelley and Firestein's Textbook of Rheumatology (9th ed.). Elsevier.
  • Braun, J., & Sieper, J. (2007). Ankylosing spondylitis. Lancet, 369(9570), 1379-1390.
  • Chhana, A., & Dalbeth, N. (2015). The gouty tophus: a review. Current Rheumatology Reports, 17(2), 9.
  • Dalbeth, N., Gosling, A., & Cacheux, S. (2016). Calcium pyrophosphate deposition disease: new insights into pathogenesis and clinical features. Nature Reviews Rheumatology, 12(3), 135-142.
  • Tsokos, G. C. (2011). Systemic lupus erythematosus. New England Journal of Medicine, 365(22), 2110-2121.
  • Centers for Disease Control and Prevention (CDC). (2020). Fibromyalgia Facts. https://www.cdc.gov
  • National Institute for Health and Care Excellence (NICE). (2014). Gout: diagnosis and management. NICE Guideline CG177. https://www.nice.org.uk

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