Posted: June 12th, 2023

G.J. is a 71-year-old overweight woman

Musculoskeletal Function:
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.
Case Study Questions

Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
Superior Essay Writers Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
How would you handle the patient concern about osteoporosis?Page Paper Describe your interventions and education you would provide to her regarding osteoporosis.
Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.
Case Study Questions

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Case Study 1: Musculoskeletal Function

Osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown and loss of cartilage in the joints. It commonly affects weight-bearing joints such as the knees, hips, and spine. Osteoarthrosis, on the other hand, is a broader term that encompasses any joint disease with degenerative changes, including osteoarthritis. It is important to note that osteoarthrosis is a nonspecific term and can refer to degenerative changes in any joint, while osteoarthritis specifically refers to degeneration in weight-bearing joints.
The risk factors presented in the case that contribute to the diagnosis of osteoarthritis are:
a) Age: Being 71 years old puts the patient at a higher risk for developing osteoarthritis as it is more prevalent in older individuals.
b) Overweight: The patient is described as overweight, and excess weight puts increased stress on weight-bearing joints like the knees, leading to accelerated wear and tear.
c) Joint injury: The patient’s long history of bilateral knee discomfort suggests that she may have experienced joint injuries in the past, which can increase the risk of developing osteoarthritis.
d) Familial predisposition: The patient has a family history of osteoporosis, which may indicate a genetic predisposition to musculoskeletal conditions.

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Osteoarthritis (OA) and rheumatoid arthritis (RA) are two distinct types of arthritis with different clinical manifestations, major characteristics, joints affected, and diagnostic methods.
Clinical Manifestations:
OA: Gradual onset of joint pain, stiffness, and swelling. Pain is typically worse with activity and relieved by rest. Joint deformities may develop over time.
RA: Symmetrical joint involvement, morning stiffness lasting more than one hour, fatigue, general malaise, and systemic manifestations such as fever and weight loss.

Major Characteristics:
OA: Degenerative changes in joint cartilage, bone remodeling, osteophyte formation (bone spurs), and joint space narrowing.
RA: Autoimmune disorder characterized by chronic inflammation, synovial hypertrophy, pannus formation (invasive synovial tissue), joint erosion, and systemic involvement.

Joints Usually Affected:
OA: Weight-bearing joints (knees, hips, spine) and small joints of the hands.
RA: Small joints of the hands, wrists, feet, ankles, and often involves symmetrically paired joints.

Diagnostic Methods:
OA: Clinical assessment, medical history, physical examination, X-rays, and sometimes joint fluid analysis.
RA: Clinical assessment, medical history, physical examination, laboratory tests (rheumatoid factor, anti-cyclic citrullinated peptide antibodies), and imaging (X-rays, ultrasound, MRI).

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Treatment alternatives for osteoarthritis include both non-pharmacological and pharmacological approaches.
Non-pharmacological interventions:

Weight management: Encouraging weight loss can alleviate stress on the joints and reduce pain.
Physical therapy: Strengthening exercises, range-of-motion exercises, and low-impact aerobic activities can improve joint function and reduce pain.
Assistive devices: Using canes, walkers, or braces can provide support and reduce joint stress.
Heat or cold therapy: Applying heat or cold to affected joints can help reduce pain and stiffness.
Occupational therapy: Assisting with adapting daily activities to reduce joint strain.
Pharmacological interventions:

Analgesics: Acetaminophen or tramadol can be used for pain relief.
Homework Help – Topical agents: Nonsteroidal anti-inflammatory drugs (NSAIDs) in cream or gel form can be applied to the skin over affected joints.
Intra-articular injections: Corticosteroids or hyaluronic acid injections may be

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