presentation revised djd

8/8/2019 Presentation Revised Djd

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Degenerative Joint DiseaseOsteoarthritis


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DJD or Osteoarthritis is the natural break down andrepair process that occurs with cartilage.

With osteoarthritis this process does not occur like itshould therefore there is cartilage deterioration andan abnormal repair process.

Eventually he smoothsurface of the cartilagebegins to deteriorateand become worncausing friction between

``````````````` the bones.


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Signs and Symptoms:1st -Pain or stiffness in one or more joints (usually weight bearing)

Localized to the affected joints and may be described as a deep achPain is aggravated by use or motion of the joint and relieved at rest

Pain at night may be accompanied by numbness, and tingling .

Stiffness

Tenderness to touch

Crepitus (sound of rubbing bone fragments)

Enlargement

Deformity

Subluxation

Synovial effusion


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Different Joints have different Signs and

Symptoms

Interphalangeal Joints: HeberdensNodes-bony enlargement of distal

joints may cause pain, redness,swelling of Bouchards nodes-bonyenlargement of proximal joints.


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First Carpometacarpal:swelling at base of thumbcrepitus with movementsquared appearance ofjoint


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Spine:Localized pain and stiffnessMuscle spasmLimited ROMNerve root compression withradicular pain and motor weakness


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Hips:Pain referred to inguinal areabuttock ,thigh or kneeLoss of internal rotationLimited extension, adductionand flexion


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Knees:

Pain in the bony enlargementEffusionsCrepitusInstability and deformity withadvanced disease


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The goals of treatment are to:Increase the strength of the jointsMaintain or improve joint movementReduce the disabling effects of the diseaseRelieve pain


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MEDICATIONS:

Over-the-counter pain relievers can help with symptoms. Mostdoctors recommend acetaminophen (Tylenol) first, because it hasfewer side effects than other drugs.If your pain continues, your doctor may recommend nonsteroidalanti-inflammatory drugs (NSAIDs). These drugs help relieve painand swelling. Types of NSAIDs include aspirin, ibuprofen, and

naproxen.However, long-term use of NSAIDs can cause stomach problems,such as ulcers and bleeding. These drugs may also increase the riskfor heart attacks and strokes.

The prescription drug, Celebrex (a COX-2

inhibitor) may work as well as other NSAIDs.Because of a risk for heart attacks and stroke, it isgiven only at the lowest possible dose for theshortest possible period of time.


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Corticosteroids injected right into the joint can also be usedto reduce swelling and pain. However, relief only lasts for ashort time.Many people use over-the-counter remedies such as

glucosamine and chondroitin sulfate. There is some evidencethat these supplements can help control pain, although they donot seem to grow new cartilage. Some doctors recommend atrial period of 3 months to see whether glucosamine andchondroitin work.

Capsaicin (Zostrix) skin cream may help relieve pain. You mayfeel a warm, stinging sensation when you first apply thecream. This sensation goes away after a few days of use. Painrelief usually begins within 1 - 2 weeks.Artificial joint fluid (Synvisc, Hyalgan) can be injected into

the knee. It may relieve pain for 3 - 6 months.

Medications Continued.


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Exercise helps maintain joint and overall movement. Askyour health care provider to recommend an appropriate homeexercise routine. Water exercises, such as swimming, are

especially helpful.

Other lifestyle recommendations include:Applying heat and coldEating a healthy, balanced diet

Getting restLosing weight if you are overweightProtecting the jointsPeople whose work is causing stress in certain jointsshould find ways to reduce trauma. You may need toadjust the work area or change work tasks.

LIFESTYLE CHANGES


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Physical therapy can help improve muscle strength and the motion at stiff joints.

Therapists have many techniques for treating osteoarthritis. If therapy does not make

you feel better after 3 - 6 weeks, then it likely will not work at all.

BRACES

Splints and braces can sometimes support weakened joints. Some prevent the jointfrom moving; others allow some movement. You should use a brace only when your

doctor or therapist recommends one. Using a brace the wrong way can cause joint

damage, stiffness, and pain.

SURGERYSevere cases of osteoarthritis might need surgery to replace or repair damaged joints.

Surgical options include:

Arthroscopic surgery to trim torn and damaged cartilage

Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)

Surgical fusion of bones, usually in the spine (arthrodesis)

Total or partial replacement of the damaged joint with an artificial joint (kneearthro last , hi arthro last)

Physical Therapy


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Patient education is an important part of OA treatment because ofthe highly individual nature of the disorder and its potential impacton the patient's life. Patients who are depressed because ofchanges in employment or recreation usually benefit from

participation in self-help groups, or counseling. The patient's familyor friends should be involved in discussions of coping, householdreorganization, and other aspects of the patient's disease andtreatment regimen.

Nursing Care

The nurse should also teach thept the correct use of anyprotective measure-such asbending, lifting with the affectedjoint correctly.

The aim is to relieve painand swelling and keep thejoint functioning.


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Nursing Care

Exercise and Medication administration are essentialin the nursing care of an individual with DJD.

Encourage overweight individuals with DJD to loose

the weight.

presentation revised djd

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