pt 214 presentation

8/8/2019 PT 214 Presentation

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Osteoarthritis


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Osteoarthritis is a chronic, degenerative disorder ofmultiple etiology, characterized by loss of articularcartilage and periarticular bone remodeling.

Causes

` Previous knee injury` Repetitive strain on the knee` Fractures, ligament tear, and meniscal injury -affect

alignment; promote wear and tear.

` Genetics` Obesity


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` Pain: worsen following activity,` Stiffness at rest- quickly goes away with activity

` Limited range of motion in the knee

` Localized swelling

` X-rays: joint space narrowing, bony enlargements andosteophyte formation.

` Joint tenderness

` Crepitus- (crackling, grinding noise with movement)

` Local inflammation` OA progresses- Pain continuous even when not weight-

bearing


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` Oral medications: Acetaminophen, Opioid

analgesics , NSAIDS ( ibuprofen, naproxen,

dicofenac, meloxicam)

` Corticosteroid injections` Topical creams and gels

Conservative

` Education

` Physical therapy ROM exercise, musclestrengthening, aerobic conditioning.

` Weight loss


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` The program should be individualised after considering:` Severity of pain` Joint stability

` The program should include:` Warm-up 5 minutes. Range-of-movement exercises.

` Flexibility exercises daily stretching and range-of-movementexercises.` Strengthening exercises (a) Isometric exercises (static muscle

contraction that does not move a joint or alter muscle length) up totwice daily during acute inflammatory periods; and (b) Isotonicexercises (resistance training exercises, often with weights), maximumtwo days per week.

` Endurance/fitness exercises such as walking, swimming, dancing,aquarobics, cycling, 34 times per week.

` The intensity, duration, and frequency of exercise should be specifiedand graded to allow for progression.


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A 64 year old Indian female presents to the Physio

outpatients complaining of left knee pain

Cues

64 year oldIndian female

Left knee-weight bearing joint

Pain


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` Fracture

` OA

` Rheumatoid arthritis

` Ligament injury ( ACL, PCL, LCL, MCL)` Meniscal injury

` Referred pain

` Tendinitis


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Name: Mrs. X Age: 64yrs Race: I Gender: F

MP: Throbbing pain on the medial and lateral sideof the left knee joint.

HPC: Pain started in September last year with noclear onset. She was been seen by a privatedoctor for her knee and was taking antinflammatory drugs. Upon her diabetes checkup atCWM the doctor referred her to Physio

outpatients.PrMHx: Diabetes Mellitis, HTN, Chronic Renal

Failure stage II since past 2 years.


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` PMHX: Eye surgery last year Nov for cataracts

` Aggravating factors- walking, sitting for long withlegs hanging.

` Easing factors- Rest

` 24 hr behavior: Pain doesnt change with time

` Severity: 8/10 pain

` SHX: Retired nurse, living with her husband.

`

FHX:` SQ: Poor eyesight, no previous injuries to her left

knee. Hobbies: Sewing and gardening


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` Investigations: X-ray showed narrow joint space.

` Medications:

T Gleprgide 5mg

T ASA 150 mgT Enalpril 5mg

T Simrotatin


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12/12

` Surface heat to the superficial regions of the body.

pt 214 presentation

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