it is about the type of joint disorder i.e Rheumatoid arthritis its causes symptoms and treatment

1. JOINT DISORDERS
PoojaDeori

2. INRODUCTION
A JOINT is where two or more bones come
together like knee, hip, elbow, shoulder
etc.
Joint can be damaged by nonsystematic
non inflammatory disorder i.e.
associated with Aging & Trauma
In this there is ulceration of articular
cartilage that leaves the underlined bone
exposed

3. The treatment of joint disorder
depend upon the cause E.g. If a
person have any injury the
treatment often begin with
RICE (REST ICE COMPRESSION &
ELEVATION)

4. DEFINITION
JOINT DISORDER is defined as
an abnormal condition that
involve any aspect of joint
caused by infection,
inflammation, chronic
repetitive injury, degeneration,
congenital deformity, neoplasm
etc.

5. TYPES OF JOINTDISORDER
There are various disorders which affects the
joints these are as follows -:
RHEUMATOID ARTHRITIS
 OSTEOARTHRITIS
GOUT
BACTERIAL & SEPTIC ARTHRITIS
SPONDYLOARTHROPATHIES
BURSITIS
TENDONITIS

6. OSTEOARTHRITIS (OA)
 Degenerative joint disease
 Most common joint disease
 Involves the entire synovial joint
 Preferentially affects weight bearing
joints
e.g. Hips, knees, spine (vertebrae)

7. “Acute, monoarticular, inflammatory arthritis”
 Characterized by hyperuricemia
 Decreased excretion via kidneys or
Overproduction of uric acid Primarily in
joints, subcutaneous tissue, and kidneys
 E.g. toe, ankle, instep, knee, wrist, elbow,
fingers
 Occurs primarily in middle age men
GOUT

8. BACTERIAL & SEPTIC
ARTHRITIS
Description: joint inflammation
as a result of an infection by
bacteria, virus, parasites, or
fungi; can damage tissue
Symptoms: joint pain, redness,
swelling, decreased ROM,
weight loss, fatigue,
fever/chills

9. SPONYDYLOARTHROPATIES
 It is a long term chronic disease of joint.
 these occur in children
 It involve attachment between your low
back & pelvis.
 Affect areas around the joints where
ligament & tendon attach to bone
 E.g. knee, foot, hip etc

10. BURSITIS ARTHRITIS
Description: Swelling of
the bursa (fluid pouch
around joint)
Symptoms: Swell/Pain
when pressure applied,
pain, stiffness

11. TENDONITIS
Description: High
concentration of urate
crystals in blood
Symptoms:
inflammation/tenderness,
pain, redness (usually in
the foot)

12. RHEUMATOIDARTHRITIS
DEFINITION
It is defined as an auto immune
disease in which the body immune
system attacks the joints & cause
inflammation & pain in & around
the joints

13. ETIOLOGY
 CHRONIC SYSTEM INFLAMMATORY
DISEASE
 GENETIC & FAMILIAL PREDISPOSITION
 OBESITY
 WEAK IMMUNE SYSTEM
 AGE
 SMOKING
 BACTERIA & VIRUS
 AIR POLLUTION
 INSECTICIDES
 MINERAL OIL

14. PATHOPHYSIOLOGY
Due to Etiological factor
Antigen –Antibody Response
Transformation of IgG & IgM into rheumatoid
factor
Formation of immune complex into blood &
synovial fluid
Primarily involve the synovial joint

15. cont
Inflammation stimulus in growth of vessels &
proliferation of synovial cells
Pannus develops covers the surface like articular
sheet
Cartilage destroyed & erode the underlying bone
Joint become immobilized
Undergoes osteoporosis & enclosing
Chronic inflammatory joint disease

16. SKINMENIFESTATION

17. Cont

18. Cont

19. Cont

20. CARDIACMENIFESTATION

21. Cont

22. PULMONARYMENIFESTATION

23. NEUROLOGICAL
MENIFESTATION

24. Cont

25. DIAGNOSTICEVALUATION
 HISTORY COLLECTION
 Past medical History
 Present medical history
 List of allergies
 PHYSICAL EXAMINATION
 check Inflammation around the joints
 Joint stiffness
 joint fluid & nodules
 Range of motion

26. Cont
 LABORATORY TEST
 Synovial fluid analysis
 liver enzyme monitoring
 X-ray
 MRI
 Bone scan
 Ultrasound
 Synovial Biopsy
 Rheumatoid factor normal range – 0-20µl
 CBC
 Uric Acid

27. MANAGEMENT
Medical management -:
 Hydro collator packs
 Paraffin Baths
 Electric Heating pads
 MEDICATION-
o NSAIDS E.g. Ibuprofin, Naproxen Sodium
o corticosteroids e.g. prednisone
o Disease Modifying Antirheumatic Drug {DMARDS}
E.g. methotrexate, Sulfasalazine
o Biological Agent E.g. Anakinra, Golimumab

28. SURGICALMANAGEMENT
 ARTHROSCOPY
 SYNOVECTOMY
 OSTEOTOMY
 TENDON TRANSPLANTS
 ARTHRODESIS
 TOTAL JOINT REPLACEMENT

29. ARTHROSCOPY
 Arthroscopy
examination into joint
using arthroscope
with fiber optic lens,
most knee injuries
are treated with
arthroscopy.

30. SYNOVECTOMY

31. OSTEOTOMY

32. TENDON TRANSPLANT

33. ARTHRODESIS

34. TOTAL JOINT
REPLACEMENT

35. NURSINGMANAGEMENT
NURSING DIAGNOSIS &
INTERVENTIONS
DIAGNOSIS
I. CHRONIC PAIN related to swelling as
evidenced by facial expression of the
patient
INTERVENTIONS
 Assess the condition of the patient
 Apply local heat or cold to affected joint
for 15-20 min 3-4 times per day

36.  Administer or teach self administration
of pharmacological agent
Encourage patient for using adjunctive
pain control measures
E.g. PROGRESSIVE MUSCLE
RELAXATION MEDICATION
 Encourage patient for taking warm bath
or shower to decrease morning stiffness

37. DIAGNOSIS
2. ACTIVITY INTOLERANCE related to
musculoskeletal impairment evidenced
by patient is semi dependent on others.
INTERVENTIONS
 Encourage patient for gentle ROM
exercises
Use splints
Refer physical therapy
Use occupational therapy

38. DIAGNOSIS
3. RISK OF INJURY related to toxicity of drug
INTERVENTIONS
 Review the drug information before
administration to ensure baseline blood
work such as CBC, LIVER FUNCTION
Ensure that TUBERCULIN test has been
done prior to starting biological agent
Make sure that there is no liver vaccines
should be administered in past 2-3 days
before drug administration

39. Administer medication subcutaneously by
rotating site of abdomen
DIAGNOSIS
4. SELF CARE DEFICIT related to
limitation secondary to disease
process.
INTERVENTIONS
Provide pain relief drugs before self care
activities.
Conduct an environment for performing
daily activities.

40. Schedule adequate rest period.
Discuss importance of promoting the
patient’s self care at appropriate level.

41. HEALTHEDUCATION
Instruct patient & family in the nature
of disease E.g. RA has no cure avoid
MIRACLE cure.
Educate patient about
pharmacological agent.
 encourage patient for doing
exercise.
 patient should be advised not to take
heavy load.
 patient should be advised to quit
smoking
Patient should be educated regarding

42. THANK YOU