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NR 603 Week 5 Virtual Interactive Student - VISE Call.

Chamberlain University Nursing NR 603 Advanced Clinical Diagnosis and Practice across the Lifespan Practicum Arlen Specter 3 pages
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A thorough history and physical exam (with a focused musculoskeletal exam) should be performed on all patients, with some findings summarized above. OA is a clinical diagnosis and can be diagnosed with confidence if the following are present: 1) pain worse with activity and better with rest, 2) age more than 45 years, 3) morning stiffness lasting less than 30 minutes, 4) bony joint enlargement, and 5) limitation in range of motion. A differential diagnosis should include rheumatoid arthritis, psoriatic arthritis, crystalline arthritis, hemochromatosis, bursitis, avascular necrosis, tendinitis, radiculopathy, among other soft tissue abnormalities.[9][10] Blood tests such as CBC, ESR, rheumatoid factor, ANA are usually normal in OA, although they may be ordered to rule out inflammatory arthritis. If the synovial fluid is obtained, the white blood cell count should be less than 2000/microL, predominantly mononuclear cells (non-inflammatory), which is consistent with a diagnosis of OA. X- rays of the affected joint can show findings consistent with OA, such as marginal osteophytes, joint space narrowing, subchondral sclerosis, and cysts; however, radiographic findings do not correlate to the severity of disease and may not be present early in the disease. Differentials include: • Rheumatoid arthritis, Psoriatic arthritis, Crystalline arthritis, Bursitis • Tendinitis • Hemochromatosis • Avascular necrosis • Radiculopathy • Other soft-tissue conditions

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