Question

Case Study

Mary Pearl, age 60, has come into the physician's office complaining of swelling, stiffiness, and arthralgia, especially in her elbows, wrists, and hands. A bone scan revealed acute inflammation in multiple joints with damaged articulate cartilage and an erythrocyte sedimentation rate blood test indicated a significant level of acute inflammation in the body. A diagnosis of acute episode of the rheumatoid arthritis was made. The physician ordered nonsteroidal anti-inflammory medication and physical therapy. The therapist initiated a treatment program of hydrotherapy and AROM exercises.

1. What pathological condition does this patient have? Look this condition up in a refernce source and indicate a short description of it.

2. What type of long-term damage may occur in a patient with rheumatoid arthritis?

3. Describe the other major type of arthritis mentioned?

4. What two diagnostic procedures did the physcian order? Describe them in your own words. What were the results?

5. Whar treatments were ordered? Explain what the physical therapy procedures involve?

6. This patient is experiencing an acute episode. Explain what this phrase means and contrast it with chronic?

Answer 1

1- patient is having pain , stiffness and swelling in his joints.He is diagnosed with rheumatoid arthritis that is an autoimmune systemic disorder.patient is having inflammation.patient have passed pre RA stage as deformity can be seen in bone xray.

2- As Rheumatoid is a systemic disorder there are many long term complications associated with it-

1- accelerated atherosclerosis ( most common cause of death in RA.)

2-Cervical myopathy

3- dry eye and scleritis

4- hematological condition- anaemia of chronic disease

5- pericarditis without tamponade

6- osteoporosis

3-some major variants of arthritis other than rheumatoid arthritis are-

-osteo arthritis

- psoriatic arthritis

-axial spondylitis

- gout

- lupus.

4-two diagnostic test tht physician ordered were -

1-bone scan

2- Erythrocyte sedimentation rate.

In bone scan damage in the articular cartilage is observed and damage to cartilage and erosion in bones is a signal of rheumatoid arthritis.

ESR tells the time duration RBC takes to settle down in anticoagulated blood.High ESR indicates inflammation, here in this patient ESR is raised.

5- treatment ordered were non steroidal anti inflammatory drugs and physical therapy.

Since it is an inflammatory condition NSAIDS will reduces the inflammation and relieving the pain stiffness and other system, it will delay the further progression of disease by inhibiting the inflammation.

Physical therapy can effectively relieve the pain and inflammation aerobic exercises, walking, yoga ,ROM exercises, stretching , strengthening should be a part of disease management.

6- acute condition is a situation where symptoms develop early, in this condition symptoms are generally severe and sudden in onset.while chronic disease develop gradually over a period of time usually months and year, its symptoms are less prominent and resolve slowly.