Académique Documents
Professionnel Documents
Culture Documents
Chapter 20: Care of Patients with Arthritis and Other Connective Tissue Diseases
Key Points - Print
OVERVIEW
Connective tissue disease is the major focus of rheumatology, the study of rheumatic
disease.
A rheumatic disease is any disease or condition involving the musculoskeletal system.
Most connective tissues diseases are classified as autoimmune disorders.
In autoimmune disease, the immune system does not recognize body cells as self and
therefore triggers an immune response; antibodies attack healthy normal cells and tissues.
Most autoimmune diseases have remissions and exacerbations.
The usual protective nature of the immune system does not function properly in patients with
autoimmune connective tissue disorders.
Be aware that most of the connective tissue diseases and arthritic disorders have a genetic
basis as part of their etiology; most are also classified as autoimmune diseases and have
remissions and exacerbations.
20-2
Differentiate clinical manifestations and prognosis for patients with SLE versus systemic
sclerosis (SSc).
Prioritize care by assessing for swallowing ability in patients who have systemic sclerosis
and collaborate with the nutritionist for food modifications if needed.
GOUT
Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
20-3
Monitor for acute joint inflammation in patients with a history of gout; the great toe and other
small joints are most typically affected.
Remind patients with gout to avoid factors that trigger an attack, such as aspirin, organ
meats, and alcohol.
Recognize that patients with fibromyalgia syndrome and chronic fatigue syndrome are often
frustrated because they have not been diagnosed or have been misdiagnosed.
Teach patients with fibromyalgia and chronic fatigue syndrome that antidepressant drugs can
promote sleep and decrease pain as well as prevent or treat the depression that is common
with these illnesses.
Teach people ways to prevent or detect early Lyme disease.
Ankylosing spondylitis is also known as Marie-Strmpell disease or rheumatoid spondylitis.
The disease affects the vertebral column and causes spinal deformities. Other features include
iritis, arthritis or arthralgia, and nonspecific systemic manifestations such as malaise and
weight loss.
Remind patients to avoid crowds and other possible sources of infection when they are taking
immunosuppressant drugs.
Monitor and interpret laboratory test results for patients with autoimmune connective tissue
diseases.
In summary:
Collaborate with the health care team to manage chronic pain and increase mobility for
patients with arthritis and other CTDs.
Reinforce the importance of good health practices, such as adequate sleep, proper nutrition,
regular exercise, and stress-management techniques for patients with arthritis and other CTDs.
Encourage patients with arthritis and connective tissue diseases to discuss their chronic illness
and identify coping strategies that have previously been successful.
Be aware that chronic, painful diseases affect the patients quality of life and role
performance.
Provide information about community resources for patients, especially professional
organizations such as the Arthritis Foundation and Lupus Foundation.