Rehabilitation of orthopedic and rheumatologic disorders. 4. Rheumatoid arthritis and calcium pyrophosphate deposition disease

Arch Phys Med Rehabil. 2005 Mar;86(3 Suppl 1):S61-8. doi: 10.1016/j.apmr.2004.12.011.

Abstract

This self-directed learning module highlights a clinical vignette of 2 patients: (1) a woman with bilateral, distal, upper-limb pain assessed by differential diagnosis, laboratory work-up, and treatment of rheumatologic disorders frequently seen in the physiatric practice setting and (2) a 57-year-old man with an acute recurring monoarthritis of the knee and addresses clinical presentation, assessment, medical management, and rehabilitation approaches. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on 2 aspects: (1) the differential diagnosis of polyarthralgia, distal upper-limb pain, criteria for classification of rheumatoid arthritis, synovial fluid analysis, and comprehensive treatment of rheumatoid arthritis, both pharmacologic and nonpharmacologic and (2) the differential diagnosis, clinical diagnostic considerations, current pharmacotherapy, invasive procedure options, and orthotic and exercise interventions for a patient with calcium pyrophosphate dehydrate-induced monoarthritis of the knee.

Overall article objectives: (a) Clinical evaluation, diagnosis, management, and rehabilitation strategies in persons with initial presentations of inflammatory distal upper-limb pain and (b) clinical evaluation of an individual with crystal-induced monoarthritis and differentiation of the pathophysiology, assessment, and treatment of chondrocalcinosis.

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / rehabilitation*
  • Chondrocalcinosis / diagnosis
  • Chondrocalcinosis / rehabilitation*
  • Diagnosis, Differential
  • Exercise Therapy
  • Female
  • Humans
  • Knee Joint / diagnostic imaging
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / diagnosis
  • Radiography
  • Synovial Fluid / chemistry
  • Wrist Joint / diagnostic imaging