Talk:Casus 15/@comment-24.132.19.156-20140723112425

Gewrichtsaandoeningen:

- Artrose (multifactorieel)

- Trauma (acuut)

- Ontsteking (arthritis)

- Infectie (bacteriële arthritis)

- Reactief (proxitis fugax; tijdelijke ontsteking op/rond het gewricht, vaak bij kinderen na een BLWI)

- Auto-immuun (steriele ontsteking)

- Overbelasting (tendinitis, arthrose)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Aangeboren (klompvoet, heupdysplasie)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">

<p class="MsoNoSpacing"> <span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">Reumatoide arthritis (RA):

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Chronische symmetrische, inflammatoire polyarthritis

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Prevalentie ± 1% van de bevolking, Vrouw/man: 3:1.

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Langdurige ochtendstijfheid (arthrose 5-10min, RA 30-60min)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Laag Hb

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Verhoogde BSE

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Reumafactoren

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Autoimmuun proces, IgG, reumafactoren

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Synovitis gewrichten en pezen

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Destructie kraakbeen

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Pannusvorming (kraakbeen vervangen door granulatieweefsel)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Lokale destructie (boterosie)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Osteoporose botuiteinden (minder grip schroeven bij OK)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Cystevorming

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Ossale collaps

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Dislocaties

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Fibrose, contracturen, verstijving (contracturen)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Synovitis rond pezen

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Ruptuur rond benige randen

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Druk op zenuwen (n. medianus, n. ulnaris); synovitis, villi die veel volume innemen => carpaaltunnelsyndroom

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Kniekuilcyste

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Instabiliteit (CWK, temperomandibulair)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Systemische ziekte

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Extra-skeletale manifestaties: Scleritis, Syndroom van Sjögren, Lymfadenopathie, Pericarditis, Pleuritis/fibrose, Amyloidose, Splinterbloedingen, Vasculitis, Splenomegalie, Perifere neuropathie. <p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">R/ Beheersen ziekte, voorkomen verdere schade met NSAIDs (symptoombestrijding), Methotrexaat, Corticosteroiden, Biologicals (TNFalfa blokkers, IL-1 blokkers)

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">Fysiotherapie: behoud mobiliteit,voorkomen contracturen. Ergotherapie: spalken, brace.

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">R/ Chirurgie:

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Behoud of herstel van validiteit

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Preventief: Peesruptuur, Neurologie bij WK instabiliteit, Teeninfecties

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight: bold;mso-bidi-font-style:italic;mso-no-proof:yes">- Reconstructief: Resectie-arthroplastiek, Arthrodese (kraakbeen eruit, vast zetten), Prothese

<p class="MsoNoSpacing"><span style="mso-fareast-language:NL;mso-bidi-font-weight:bold;mso-bidi-font-style: italic;mso-no-proof:yes">http://www.diliguide.nl/document/7759/read/8651/verschillende-soorten-ingrepen/