osteoarthritis notes 2 17

Sx

  • location
    • does not occur in wrists, elbow, ankle. If find on Xray, there must be underlying condition
    • unusual: shoulder

  • DIP, PIP, CMC
  • worse with gripping

  • As CMC joint enlarges, thumb pulls inward

  • De quervain: extend thumb extensor tendon
  • trigger finger: ask pt to open and close hand. One finger gets stuck

  • OT can splint

Shoulder OA

  • most common place: 3

DJD Spine

  • pain anywhere neck to lumbar
  • worse with activity, better laying down
  • prolong hx
  • Back pain ddx: compression fx, sciatica, paraspinal, spinal stenosis, infection/abscess, mass/malignancy, cord compression, sponlyarthropathies
  • straight leg raise: have pt point to exactly where it hurts. Thigh = hamstring. Groin = hip. Sciatica = pain to foot, shooting

Spinal stenosis

Treatment

  • fusion surgery makes joint worse above and below surgery

Hip pain

  • has to point to hip. Muscle spasm if point to buttocks/back
  • cane: used on the opposite arm. Right hip hurt, hold cane on left hand. Cane should come up to level or wrist
  • steroids lasts up to 3 months

Knee

  • push knee cap side to side on bed = patellofemoral
  • prepatellar bursitis: maiden's knee. Squatting or kneeling too much. Press on knee cap
  • anserine bursitis: medial side of tibia
  • tendonitis of quadriceps

Foot pain