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TUGAS REHABILITASI MEDIK

Nama: Feblin Versiliantina

NIM : 54081001029

1. Case :35 years old man, 9 years ago begin with progressive increasing painful swelling of both

hands. Later on the forth and fifth of ankle, joint of knee, elbow, hands, hip and shoulder

joint became increasingly involved. Deformity of the forth foot are prominent.

Clinical findings:

Extreme hallux valgus with reactive bursitis over the metatarsophalangeal jointtogether with refractory pressure sore.

Tibial deviation of other foot and metatarsophalangeal joint of the same foot fail toroll forward when the patient walk.

Walking any distance is only possible with orthopedic foot wear.Laboratory findings:

ESR: 57/112 mm/hr Uric acid level: 5,4 mg/dl Rheumatoid factor: detectable.X-ray: numerous joint of the feet shows pronounce erosion.

Question: what would be your diagnosis? (DD & WD)

Answer : Diagnosis is Rheumatoid Arthritis

: Differential Diagnosis is Osteoarthritis and Gout

2. How to rehabilitate a patient with Rheumatoid Arthritis Juvenille?Flexibility training can help enhance child's range of motion around the joints that arestiff because of juvenile rheumatoid arthritis. Flexibility training will increase the

elasticity of the tendons and ligaments that support and stabilize the joints of child's body.

Increasing their elasticity will take pressure off of a joint that is swollen, or is supported

by chronically tight muscles due to the secondary effects of rheumatoid arthritis. A

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physical therapist will prescribe proper flexibility training exercises that are specific to

child's needs.

Strength-training involves using muscles in such a way that they increase in size and

strength. Increasing child's muscle strength can remove excess pressure that is placed on

joints as a result of juvenile rheumatoid arthritis. Strength-training uses resistance

provided by your own body weight, resistance bands, free weights, or weight training

machines. Child's physical therapist will provide with an exercise prescription, outlining

the types of resistance training exercises recommended for child's condition.

Deep tissue massage can help decrease swelling, remove loose cell parts, and break up

collagen that has formed around your child's arthritic joints. Deep tissue massage

involves a qualified professional massaging your muscles and joints around the area of

arthritis in effort to relieve pressure. Rheumatoid arthritis can cause the buildup of fluids,

cellular waste, and a fibrous tissue called collagen, all of which can lead to pain,

discomfort, and a loss of range of motion around your joint.

Ultrasound therapy can be used to relieve chronic pain and promote tissue healing

because of juvenile rheumatoid arthritis. Ultrasound therapy is a technique used by your

child's physical therapist that involves the use of a hand-held device that comes in contact

with the surface of your skin and transmits sound waves that penetrate the soft tissues of

your child's body. The sound waves cause a rapid vibration in the soft tissues surrounding

your joints, thereby promoting the removal of cellular waste and promote the body's

natural healing process.

Last, Consult your physician to determine what kind of long-term rehabilitation program

is right for your child.