Arthritis of the Upper Extremity: Conservative Management
Description
This course will guide rehab professionals to a thorough understanding of how to evaluate and treat adult patients who have been diagnosed with upper extremity arthritis. (This course does not address juvenile arthritis.) The material covers four arthropathies that can significantly affect upper extremity function—osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and systemic sclerosis. The course discusses arthritis pathophysiology, epidemiology, relevant anatomy, and the effects on function. It also reviews evaluation of the patient with arthritis and discusses in detail conservative treatment options for these patients, aimed at maximizing each patient’s functional outcomes. Therapist Tips and Clinical Thinking scenarios help focus the clinician’s application of the material. This course will be immediately useful in clinical practice for Rehab professionals.
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Physicourses is an AOTA Approved Provider of professional development. Course approval ID# 6295. This distance learning-independent course is offered at 0.9 CEUs Intermediate Level, OT Service Delivery, Foundational Knowledge. AOTA does not endorse specific course content, products, or clinical procedures.
Available Course Credits
| Alaska State PT & OT Board | 9.00 | ||
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AOTA | 9.00 | |
| Arizona State Board of Physical Therapy | 9.00 | ||
| Arkansas State Board of Physcial Thearpy | 9.00 | ||
| California Physical Therapy Board | 9.00 | ||
| Colorado Division of Professions and Occupations | 9.00 | ||
| Delaware Examining Board of Physical Therapists and Athletic Trainers | 9.00 | ||
| District Of Columbia Department of Health | 9.00 | ||
| FPTA | 9.00 | ||
| Georgia State Board of Physical Therapy | 9.00 | ||
| Hawaii Board of Physical Therapy | 9.00 | ||
| Idaho Physical Therapy Licensure Board | 9.00 | ||
| Illinois Department of Professional Regulation | 9.00 | ||
| Indiana Physical Therapy Board | 9.00 | ||
| Iowa Board of Physical Therapy and Occupational Therapy | 9.00 | ||
| Kansas State Board of Healing Arts | 9.00 | ||
| Kentucky Board of Physical Therapy | 9.00 | ||
| Louisiana Physical Therapy Board | 9.00 | ||
| Maine Board of Physical Therapy | 9.00 | ||
| Maryland Board of Physical Therapy | 0.90 | ||
| Massachusetts Board of Allied Health Professionals | 9.00 | ||
| Michigan Board of Physical Therapy | 9.00 | ||
| Minnesota Board of Physical Therapy | 9.00 | ||
| Mississippi State Board of Physical Therapy | 9.00 | ||
| Missouri Advisory Commission for Physical Therapists | 9.00 | ||
| Montana Board of Physical Therapy Examiners | 9.00 | ||
| Nebraska Department of Health and Human Services | 9.00 | ||
| New Mexico Physical Therapy Board | 9.00 | ||
| New York State Education Department | 9.00 | ||
| North Carolina Board of Physical Therapy Examiners | 9.00 | ||
| North Dakota Board of Physical Therapy | 9.00 | ||
| Oklahoma Physical Therapy Board | 9.00 | ||
| Oregon Board of Physical Therapy | 9.00 | ||
| Pennsylvania State Board of Physical Therapy | 9.00 | ||
| Physical Therapy Governing Board New Hampshire | 9.00 | ||
| South Carolina Board of Physical Therapy | 9.00 | ||
| South Dakota Physical Therapy License Board | 9.00 | ||
| State of Alabama Board of Physical Therapy | 9.00 | ||
| State of Rhode Island Department of Health | 9.00 | ||
| Tennessee Board of Physical Therapy | 9.00 | ||
| Texas Physical Therapy Association | 9.00 | ||
| Utah Physical Therapy Licensing Board | 9.00 | ||
| Virginia Board of Physical Therapy | 9.00 | ||
| Washington State Board of Physical Therapy | 9.00 | ||
| West Virginia Board of Physical Therapy | 9.00 | ||
| Wisconsin Physical Therapy License Board | 9.00 | ||
| Wyoming Board of Physical Therapy | 9.00 |
Course Content
| 451a Arthritis of the Upper Extremity: Conservative Management | Module | ||
| Course Evaluation | Module |
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.
451a Arthritis of the Upper Extremity: Conservative Management—Course Objectives
After successfully completing this continuing education course, the learner should be able to:
- Identify the main classifications of arthritis
- Recall the epidemiology of arthritis in the U.S.
- Recall the pathophysiology of osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and systemic sclerosis (scleroderma)
- Identify the risk factors and clinical presentation of each of four arthropathies
- List diagnostic procedures used to identify these 4 types of arthritis
- Identify applied anatomy (bones and joints) of the upper extremity
- Recognize arthritic changes of the wrist and hand in the various types of arthritis
- Identify components of a thorough evaluation of a patient with upper extremity arthritis
- Recall components of patient education needed for patients with the various types of arthritis
- Recall and identify conservative therapeutic interventions for upper extremity arthritis including pain management, edema reduction, exercise, and orthoses
- Identify and apply rehabilitation strategies for a variety of arthritis conditions to help clients regain function using case studies
- 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
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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
This course is approved for 0.9 CEUS. 9 contact hours
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