Simone

MariaE
Mind Map by MariaE, updated more than 1 year ago
MariaE
Created by MariaE about 6 years ago
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Simone

Resource summary

Simone
  1. General Info
    1. Plays netball
      1. Swelling and redness
        1. Increased in the past 6 months
          1. After game
        2. Swims
          1. 9 yr old
            1. HAQ 5/24
              1. Not great for age
            2. Pain in knees, wrists, and hand.
              1. Diagnosed Juvenile Idiopathic Arthritis
                1. X ray
                  1. Osteopenia
                  2. Pauciarticular
                    1. Pathophysiology of JIA
                      1. Body can't distinguish between healthy tissue and bad tissue
                        1. Increased inflammatory response
                          1. Cell proliferation
                            1. Synovial membrane mass
                              1. Soften and weaken cartilage
                                1. Erodes cartilage
                                  1. Erodes joint
                                    1. Laxity of ligaments and capsule
                                2. Increased articular pressure
                                  1. Surrounding soft tissue fibrosis and contracture
                                  2. Pannus
                                    1. Stiffening of joint cavity if uncontrolled
                                    2. Thickens
                                  3. increased synovial fluid (effusion)
                                    1. Increase in pressure
                                  4. Increased cytokines
                                  5. Not sure what causes it
                                    1. Form of RA
                                      1. JIA effects growth
                                    2. Diagnosis
                                      1. 3 types
                                        1. Poly
                                          1. More than 5 joints
                                          2. Pauci
                                            1. Best prognosis
                                              1. 4 joints or less in first 6 months
                                                1. Spontaneous recovery
                                                2. Systemic
                                                  1. Fever, rash
                                                3. If lasts for more than 6 weeks
                                                4. Diff Diagnosis
                                                  1. Osgood Schaltter's
                                                    1. Avulsion of quad tendon
                                                      1. NOT
                                                        1. Prominent tib tuberosity
                                                          1. X ray
                                                            1. No tight quads/hammys
                                                          2. Haemophilia
                                                            1. Blood doesn't clot
                                                              1. NOT
                                                                1. No nose bleeds
                                                                2. Need to be vary due to medication
                                                                3. Bechets Disease
                                                                  1. Autoimmune
                                                                    1. NOT
                                                                      1. Painful mouth sores
                                                                        1. Inflamed eyes
                                                                          1. Skin lesions
                                                                        2. Kawasaki
                                                                          1. NOT
                                                                            1. Neck swollen
                                                                              1. Swollen
                                                                                1. No fever
                                                                              2. Systemic Lupus
                                                                                1. NOT
                                                                                  1. Skin rashes
                                                                                    1. Fatigue
                                                                                      1. Fever, no cause
                                                                                        1. Chest pain
                                                                                          1. Generally ill
                                                                                          2. Abnormal heart rythms
                                                                                        2. Medical Management
                                                                                          1. Steroid Injections
                                                                                            1. Bad for bones
                                                                                              1. Common after NSAIDs
                                                                                                1. Immobilize post injection
                                                                                                  1. Not after wrist
                                                                                                    1. Good for knee
                                                                                                  2. Biological Therapy
                                                                                                    1. Infection
                                                                                                      1. Blocks activity of cytokines
                                                                                                        1. and other cells involved in immune response
                                                                                                      2. Surgery
                                                                                                        1. Wrist uncommon
                                                                                                          1. TKA
                                                                                                            1. Bones already deformed and weak
                                                                                                              1. Not great outcome in kids
                                                                                                              2. THA
                                                                                                                1. Improved function and pain relief
                                                                                                                  1. Surgery is challenging due to poor bone quality
                                                                                                                    1. Hip affected in 1/3 of JIA
                                                                                                                2. Physio Management
                                                                                                                  1. Acute
                                                                                                                    1. Manage pain
                                                                                                                      1. Rest
                                                                                                                        1. Avoid excessive fatigue
                                                                                                                        2. Exercise doesn't progress disease
                                                                                                                          1. Ice packs
                                                                                                                            1. Heat packs at night
                                                                                                                              1. PROM involvement
                                                                                                                                1. Kids enjoy AROM
                                                                                                                                2. Isometric
                                                                                                                                  1. Load management
                                                                                                                                  2. Chronic
                                                                                                                                    1. Fitness levels often low
                                                                                                                                      1. Retrain gait
                                                                                                                                        1. Maintenance
                                                                                                                                          1. Exercise program
                                                                                                                                            1. Hydro
                                                                                                                                              1. Land
                                                                                                                                                1. Cycling
                                                                                                                                                  1. Psychological?
                                                                                                                                          2. Medication
                                                                                                                                            1. Methotrexate
                                                                                                                                              1. Strict guidelines
                                                                                                                                                1. Needs to be constantly monitored
                                                                                                                                                  1. Used to combat cancer
                                                                                                                                                    1. 1 per week
                                                                                                                                                      1. Best 3 days post
                                                                                                                                                        1. Affects kidneys
                                                                                                                                                          1. Needs to be constantly monitored
                                                                                                                                                          2. Inhibits replication of cells in the body
                                                                                                                                                            1. Inhibits DNA synthesis
                                                                                                                                                              1. Stops folic acid production
                                                                                                                                                                1. Taken in conjunction with folic acid
                                                                                                                                                                  1. Helps reproduce good cells
                                                                                                                                                                  2. Reduces production of cells that attack joints
                                                                                                                                                                2. NSAIDs
                                                                                                                                                                  1. Naprosyn
                                                                                                                                                                    1. Large variety
                                                                                                                                                                3. Living with JIA for a 9 yr old
                                                                                                                                                                  1. Cycling with friends
                                                                                                                                                                    1. Relay swimming teams
                                                                                                                                                                      1. Dances
                                                                                                                                                                        1. Doesn't want a splint or stand out
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