Osteoarthritis
DT is an 88 year old female; she is 4’9 and 152 pounds. She recently retired from Wal-Mart in January of this year and was living at home with her husband up until her recent admission to the hospital. She presented to the emergency room with right knee pain and was admitted to the medical surgical unit. Her knee was swollen and she was unable to walk on it due to the pain it was causing her. She had synovial fluid drained from her knee and there were no signs of any organisms, but many white blood cells. Before her discharge they decided that the swelling and pain was due to inflammation arthritis due to her osteoarthritis. DT also has diagnoses of hyperlipidemia, hypertension, history of nephrolithiasis, and an arrhythmia
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Osteoarthritis can be called osteoarthrosis or degenerative joint disease; it is the most common arthritis and is a major cause of disability in adults in the United States. The joints have something called articular cartilage, sometimes called hyaline cartilage. Articular cartilage is composed of 65% to 80% water, along with proteoglycans, collage, and chondrocytes, which form a matrix. As you age the enzymes break down the articular matrix. Normally your cartilage is a bluish white, translucent color, but in the early stages of osteoarthritis it changes to an opaque and yellowish brown color. As the arthritis continues to get worse the bone beneath the cartilage begins to wear away leaving narrowed joint spaces where bone spurs can occur. As osteoarthritis progresses the cartilage will thin and inflammatory cytokines increase the corrosion. The rapid corrosion is too much for the body’s normal repair process to keep up with. Ultimately pieces of bone and cartilage break off and begin to float in the arthritic joint causing pain and stiffness and eventually lead to reduced mobility and muscle atrophy. (Ignatavicius & Workman, …show more content…
Most often it’s the bearing joints such as the hips and knees, the vertebral column and the hands that are affected because they endure the mechanical stress of the body’s weight and movements and after many years of use they wear out. Obesity is a significant risk factor of osteoarthritis especially in the knees. Being obese makes more weight for the knees to bear which can lead to joint degeneration which then can lead to osteoarthritis. Smoking is also a significant risk factor in that smoking causes loss of knee cartilage. There is also a secondary osteoarthritis that can occur, which results from musculoskeletal conditions and heavy manual occupations. (Ignatavicius & Workman, n.d.) My client had inflammation in her knee from the osteoarthritis and her risk factors were that she was heavier than she should have been for her body mass index. Although smoking is a risk factor my patient stated that she never smoked. My patient also worked at Wal-Mart for many years, she just retired in January. Working there she was on her feet for many hours a day putting stress on her joints especially her knees. After work she would then come home and make supper for her husband and do things around the house and never really resting her
Amy Widener is a real estate agent, mother of two, and a sepsis survivor. In 2013 Amy was in the best shape of her life. She had just finished a Disney half marathon and was reaping the benefits of her intense training, little did she know that that training was going to save her life. One night she woke up with extreme abdominal pain and was rushed to the emergency room where she learned that she had a kink in her intestines. They performed emergency surgery and released her after a little bit of recovery. Instead of Amy’s pain getting better with recovery after her surgery, it got worse. This resulted in subsequent trips to the E.R. only to be sent home with more and more antibiotics. Two months after her surgery she went into the emergency
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
Her previous medical history includes osteoporosis which lead to poor mobility due to pain. She is currently waiting for Total Knee Replacement. After a Total Knee Replacement , patient is more likely to suffer from pain and being immobile for a period of time before commence physiotherapy. That greatly increase the chance of developing DVT(Brown, Edwards, Seaton&Buckley, 2014) .Patient education relating to physical activity includes encouraging early ambulation.
Osteoarthritis is the most common type of arthritis, it affects millions of people around the world. It is also known as Degenerative Joint Disease or Degenerative Arthritis or Wear & Tear Arthritis. Osteoarthritis occurs when the protective cartilage in the joints wear down over time. While osteoarthritis can affect any joint in your body, it more often is seen in the knees, hips, hands, neck, and lower back it worsens as you grow older and has no known cure.
“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease” by Thomas A. Edison. Chiropractors use hands-on spinal manipulation and other alternative treatments on the spine which will enable the body to heal itself without surgery or medication. Chiropractic care began in 1895 when its founder, Daniel David Palmer, claimed any and all diseases could be healed by nothing more than just his hands. Dr. Palmer examined a janitor who was deaf for 17 years after the janitor felt his back was out of place, so Dr. Palmer gave an adjustment to what was felt to be a misplaced vertebra in the upper back. The janitor then observed that his hearing improved thanks to Dr. Palmer. Chiropractors use manipulation to restore mobility to joints restricted by tissue injury caused by sitting without proper back support. Chiropractic is primarily used as a pain relief alternative for muscles, joints, bones, and connective tissue, such as cartilage, ligaments, and tendons. About 22 million Americans visit chiropractors annually
“Elaine” is a 34-year-old white female patient with an extensive medical history. She has a history of seizures, uncontrolled diabetes since the age of fourteen, neuropathy, fibromyalgia, COPD, Sleep Apnea, and is currently suffering from two venous ulcers on her feet. She came to the ER one week ago with nausea and vomiting and was found to be in Diabetic Ketoacidosis and her wounds had become infected. She spent three days in the ICU and for one day was ventilated. She was then sent out to the Medical/ Surgical for further management 3 days ago.
Osteoarthritis is a degenerative joint condition that primarily affects the hands, spine and the ankles and hips. It is known to be associated with aging, and is concerned with the cartilage that protects the joints (the meeting place of two bones). Normal cartilage allows for bones to slide over each other uniformly, acting as a shock absorber to any damage. However cartilage in osteoarthritis, located at the ends of the bones erodes and deteriorates, causing friction and hence pain, swelling and restricted movement. Therefore in osteoarthritic both the composition and appearance of the cartilage alters, while the body attempts to repair this damaged cartilage is broken down faster than it can be built up. A defective repair process can cause bone overgrowth, bone spur/osteocytes to form which can be seen at the ends of the joints. In osteoarthritis the bones come in close contact with each other, and wear away leaving the bone exposed and unprotected.
Osteoarthritis (OA) is the most common form of arthritis, affecting more than 27 million Americans (LeMone, Burke, Bauldoff, 2011). It is caused when the cartilage in the joints breaks down, causing the bones of the joint to rub against one another. This causes pain, stiffness, and loss of motion in the joint. Osteoarthritis is most prevalent in those 65 and older, but can affect those of any age. In addition, African Americans and Hispanics report a higher incidence of arthritis than Caucasians (LeMone, Burke, Bauldoff, 2011). Although the cause is unknown, it is believed that the increasing age of the population, prevalence of obesity and injuries add to the progression of the condition. Osteoarthritis can affect any joint in the body; however, those of the hand, hip, and knee are often the most common. This condition may be asymptomatic, or may present symptoms including soreness, stiffness and pain. The symptoms are more common in the older population, those with limited activity levels, and those who are obese. Joint cartilage thins over time, causing an increased risk for symptoms in the elderly, and obesity puts extra pressure on the joints during activity. Osteoarthritis is commonly diagnosed with the use of a physical assessment along with results of radiology testing such as X-Ray and MRI.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
Osteoarthritis can be known as, or sometimes called, degenerative joint disease. Osteoarthritis (OA) is a disease that affects not only the elderly and sick, although those 55 and older are most commonly affected, people of all ages may receive osteoarthritis (OA). Approximately 27 million Americans share the same common chronic condition of the joints. Every disease is known to have its own cycle or process; well as for Osteoarthritis its process is pretty complex. In osteoarthritis (OA), at the end of the bone where they meet to form a joint, allowing movement, the cartilage covering the bone begins something called breakdown.
Arthritis affects people of all age groups. More than 100 types of arthritis are known. Among these osteoarthritis and rheumatoid arthritis having the highest incidence. One of the major causes of chronic debilitation in industrialized nations is Osteoarthritis which results from damage to the joints, which may be due to trauma, infection, or age-related wear. Rheumatoid arthritis is encountered less frequently than osteoarthritis and is estimated to affect around one per cent of the world’s population. Amongst patients of Rheumatoid arthritis, women are three times more likely to be affected by this condition than men. This condition is caused by an inflammatory process where the body starts attacking itself. Rheumatoid arthritis also affects several joints, with inflammation sometimes seen in and around the lungs, the heart, the eyes and the skin. The most commonly reported complaint by arthritis patients is pain. The pain might be from the joint itself and be a result of inflammation, damage from the disease, or through daily wear and tear. Muscle pain is also common and is caused by having to force movements against stiff and painful joints. Although range of movement in the affected joint may be limited and uncomfortable, physical exercise has been shown to benefit those with arthritis. Physical therapy has been shown to significantly improve function, decrease pain in the long term and delay the need for surgery in advanced cases. The majority of arthritis cases occur among theelderly, however the disease can occur in children as well. Over 70% of the population that get affected by arthritis in North America are over the age of 65 (4). The disease occurs more commonly in females than males in all races, age groups, and ethn...
In older people, the meniscus grows weaker with age. The tissue that makes up the meniscus becomes degenerative and much easier to tear. Meniscal injuries in older people occur as a result of a fairly minor injury, even from the up and down motion of squatting. Degenerative tears of the meniscus are commonly seen as a part of the overall condition of osteoarthritis of the knee in the older population. In many cases, there is no one associated injury to the knee that leads to meniscal tears (Sutton, 1999).
The most common musculoskeletal disorder and a major cause of disability in people over 65 years is osteoarthritis (OA) (Felson DT et al, 1987) (1). According to World Health Organization (WHO) report, OA of knee is more likely to become the fourth most important cause of disability in women, and the eighth most important cause in men (Murray CJL, Lopez AD, 1997)(2) . Primary prevention of knee OA has become a major health care aim and a clear understanding of the risk factors is required to design preventive strategies. Many investigations reported obesity, previous history of knee injury, sedentary life style, hand OA (Heberden’s nodes), and a familial history of the disease are major risk factors for OA of knee (Cyrus Cooper et al, 2000) (3). In spite of recent advancements the causes and pathogenesis of knee OA remains largely unknown (A Teichtahl, A Wluka, F M Cicuttini, 2003) (4) but however there is increasing research interest in the contribution of biomechanical variables on progression and management of the disease (Andriacchi TP, 1991) (5).
Almost everyone develops osteoarthrits as they age, some get it while in their fifties and in others it does not appear until their eighties. Osteoarthritis is the most common form that affects older people; this form of the disease wears down the cartilage mostly through overuse and injury but there are other causes. This specific form of the disease causes the cartilage to break down and the bones to rub against each other. Deformity and swelling occurs because knobs of hardened bits of cartilage develop in the joint. It forms especially if a joint has been injured many times.
Mrs. D. was admitted to the unit in 2011. She is 84 years old widow who was diagnosed with dementia, diabetes mellitus type II, hypertension, high cholesterol