2 Course PDF Bundle: All About Arthritis

Sarah R.Stillings, MA, PT, MPT, CHT

Sarah R. (Sally) Stillings is a PT and Certified Hand Therapist in Texas. She received her physical therapy degree from the University of North Carolina at Chapel Hill. Prior to becoming a therapist, Sally taught university-level writing courses and was assistant editor of The Journal of Craniomandibular Practice. In her extensive career as a PT, she has held a variety of clinical, teaching, administrative, and business roles, including general PT practitioner, upper extremity specialist, clinic manager, hand therapy clinic coordinator, continuing education (CE) instructor, and CE course administrator. She has also served as Executive Director of the Kellermann Foundation, a U.S. nonprofit organization supporting healthcare and community development in Uganda, East Africa. Her work now focuses on creating evidence-based CE materials for rehab professionals. Sally is a lifelong runner who celebrates all those who cover the ground.

223a Osteoarthritis in Older Adults—Course Objectives

After successfully completing this continuing education course, the learner should be able to:

1. Identify the main classifications of arthritis
2. Recall the epidemiology of osteoarthritis in the U.S.
3. Recall the pathophysiology of osteoarthritis
4. List the risk factors and identify the clinical presentation of osteoarthritis
5. Recognize diagnostic procedures used to identify osteoarthritis
6. Recognize elements of a thorough evaluation of a patient with osteoarthritis
7. Recall common medical interventions for clients with OA
8. Differentiate rehabilitation strategies for a variety of patients with OA
9. Choose and apply comprehensive treatment approaches to help patients regain function
10. Recognize when to refer patients for specialized care

223a Osteoarthritis in Older Adults—Table of Contents

HOUR 1

Course Instructions 2

About the Author / Course Description 3

Course Objectives 4

Table of Contents 5

Introduction 7

Chapter 1: Definitions, Pathophysiology, and Epidemiology 8

Arthritis Categories

Degenerative Arthritis

Autoimmune and Inflammatory Arthritis

Infectious Arthritis

Metabolic Arthritis (Gout)

Defining Osteoarthritis 10

Pathophysiology of Osteoarthritis 11

Articular Cartilage

How Osteoarthritis Develops

Epidemiology 14

Prevalence/Incidence: Arthritis in General

Prevalence/Incidence: Osteoarthritis 17

HOUR 2

Risk Factors 18

National Arthritis Management Objectives 20

Chapter 2: Presentation and Diagnosis 22

Clinical Presentation

Differential Diagnosis 25

Diagnostic Testing 27

Laboratory Tests

Radiography and Other Imaging Techniques 29

Conventional Radiography

Computed Tomography (CT) 32

Magnetic Resonance Imaging (MRI) 33

HOUR 3

Chapter 3: Assessment of the Older Patient with OA 35

History

General Medical and Social History

History of the Current Complaint 36

Pain Assessment 38

Special Considerations 40

Physical Examination 41

Visual Inspection

Documentation of Joint Deformities 42

Edema Assessment

Range of Motion Measurements 42

Strength Assessment 43

Gait Analysis 44

Functional Assessment

Manual Dexterity and Coordination Tests 45

Putting It All Together 46

Chapter 4: Principles of Medical Management 48

Medical Approaches

HOUR 4

Pharmacological Treatment 51

Oral Analgesics

Topical Analgesics 54

Intra-Articular Injections 55

Corticosteroids

Hyaluronic Acid/Viscosupplementation 56

Platelet-Rich Plasma (PRP)

Other Cell-Based Therapeutics

Surgical Intervention 57

Chapter 5: Rehab Intervention 61

Patient Education 63

Joint Protection Techniques 64 

Activity Modification 66

Fall Prevention

Weight Management 68

HOUR 5

Exercise 68

Aerobic Exercise 69

Range of Motion 71

Strengthening 74

Pain Management 80

Modalities

Manual Therapy 83

Assistive Devices 84

Orthoses 85

HOUR 6

Maximizing Function 86

Conclusion 87

Case Study 88

References 92

Examination 

Evaluation

451a Arthritis of the Upper Extremity: Conservative Management—Course Objectives

After successfully completing this continuing education course, the learner should be able to:

1. Identify the main classifications of arthritis
2. Recall the epidemiology of arthritis in the U.S.
3. Recall the pathophysiology of osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and systemic sclerosis (scleroderma)
4. Identify the risk factors and clinical presentation of each of four arthropathies
5. List diagnostic procedures used to identify these 4 types of arthritis
6. Identify applied anatomy (bones and joints) of the upper extremity
7. Recognize arthritic changes of the wrist and hand in the various types of arthritis
8. Identify components of a thorough evaluation of a patient with upper extremity arthritis
9. Recall components of patient education needed for patients with the various types of arthritis
10. Recall and identify conservative therapeutic interventions for upper extremity arthritis including pain management, edema reduction, exercise, and orthoses
11. Identify and apply rehabilitation strategies for a variety of arthritis conditions to help clients regain function using case studies
12. Recognize when to refer patients for specialized care

451a Arthritis of the UE: Conservative Management—

Table of Contents Page # 

HOUR 1

Course Instructions

About the Author / Course Description 3
Course Objectives 4
Table of Contents 5
Introduction 8
Chapter 1: Pathophysiology, Presentation, and Diagnosis 9
Classification of Arthritis Types 9
Degenerative Arthritis
Autoimmune and Inflammatory Arthritis 10
Infectious Arthritis
Metabolic Arthritis
Epidemiology 11
Pathophysiology of Arthritis 12
Articular Cartilage
Osteoarthritis 15
Rheumatoid Arthritis 16
Psoriatic Arthritis 18
Systemic Sclerosis (Scleroderma)
Risk Factors 19
Osteoarthritis
Rheumatoid Arthritis 20
Psoriatic Arthritis 21
Systemic Sclerosis

HOUR 2

Clinical Presentation
Osteoarthritis 22

Rheumatoid Arthritis 24
Psoriatic Arthritis 27
Systemic Sclerosis 29
Diagnostic Testing 30
Laboratory Tests 31
Radiography and Other Imaging Techniques 33
Conventional Radiography
Computed Tomography (CT) 37
Magnetic Resonance Imaging (MRI)

Clinical Thinking 39

HOUR 3

Chapter 2: Applied Anatomy
Bony Anatomy Review 40
Shoulder Girdle

Arm 42
Forearm 43
Wrist 46
Hand 48
Anatomy and Pathology of Upper Extremity Joints 49
Sternoclavicular Joint
Acromioclavicular Joint 50
Glenohumeral (Shoulder) Joint 52
Scapulothoracic “Joint” 54
Elbow Joint 55

HOUR 4

Proximal Radioulnar Joint 58
Distal Radioulnar Joint 60
Radiocarpal (Wrist) Joint 61
Intercarpal and Midcarpal Joints 63
Carpometacarpal Joints 63
Metacarpophalangeal and Interphalangeal Joints 64
Clinical Thinking 65
Musculotendinous Structures 66
Finger Extensor Mechanism
Other Upper Extremity Musculature 68
Chapter 3: Arthritic Changes of the Wrist and Hand 72
Mechanisms of Joint Changes 72

HOUR 5

Changes of Osteoarthritis
Fingers73

Thumb 75
Wrist 78
Changes of Psoriatic Arthritis 80
Changes of Systemic Sclerosis 81
Changes of Rheumatoid Arthritis 83
Distal Forearm and Wrist
Subluxation of Carpus/Zigzag Deformity
Fingers and Thumb 86
Boutonnière Deformity
Swan-Neck Deformity 88
Thumb Radial Deviation Deformity 89
Tendon Ruptures
Clinical Thinking 90

HOUR 6

Chapter 4: Therapy Evaluation 91
Therapy Evaluation Review
General Medical and Social History 92
History of the Current Complaint

Physical Examination 94
Visual Inspection 94
Range of Motion Measurements 95
Edema Assessment
Documentation of Joint Deformities 97
Sensory Evaluation
Strength Assessment 99
Clinical Thinking 100
Standardized Assessments 101
Manual Dexterity and Coordination Tests 102
Chapter 5: Conservative Management 104
Medical Approaches 104
Medications 106
Corticosteroid Injections 108
Phototherapy 110
Surgical Intervention

HOUR 7

Patient Education
Joint Protection Techniques 111

Activity Modification 113
Pain Management 115
Modalities and Manual Therapy
Edema Reduction 116
Retrograde Edema Massage
Manual Lymphatic Drainage 118
Other Edema Reduction Techniques
Clinical Thinking 120
Wound Care 120
Exercise 120
Aerobic Exercise 122
Absolute Contraindications 124
Relative Contraindications/Precautions 124
Range of Motion 126

HOUR 8

Strengthening
Dexterity 128

Orthoses 131
Prefabricated Splints and Braces 133
Custom Splint Fabrication 135
Maximizing Function 138
Conclusion 139
Appendix A: Patient Education Resources 140

HOUR 9
Appendix B: Evaluation Resources 142
References 144
Examination 152
Evaluation 165

Educational Level: Intermediate

Target Audience: PT, PTA, OT, OTA

Course Completion Requirements: Passing an online exam with 70% or greater will be required to earn continuing education credit

• Osteoarthritis in Older Adults is approved for 0.6 CEUS. 6 contact hours
• Arthritis of the Upper Extremity: Conservative Management is approved for 0.9 CEUS. 9 contact hours

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