sheath surrounding the tendon. Either condition
may be the result of trauma, and it is manifested
by pain and swelling in the inflamed area.
TREATMENTImmobilize the area and
apply moist heat. Administer analgesics for pain.
Anti-inflammatory drugs are indicated. Chronic
cases should be referred for more definitive
This is an inflammatory process of the joints
that can be broken down into the following
categories. These specific types are the most
debilitating inflammation of one or more joints
(usually multiple) that affects women more often
than men. The onset may be abrupt or gradual,
and although more commonly found in the
proximal interphalangeal joints, it may occur in
any joint. The primary symptoms are pain and
swelling in affected joints with stiffness upon
arising from sleep. Afternoon fatigue and
thickening of the synovial sheath are common,
and there may or may not be some deformity.
. RheumaticA self-limiting inflammation
of the large hinge joints (usually singular) that is
most often preceded by a history of streptococcal
. DegenerativeOsteoarthritis results from
the destruction of the hyaline cartilage. The
specific cause is unknown; however, trauma,
obesity, and age are predisposing factors.
Degenerative arthritis most often occurs at
middle age and older and is more common in
women than men. The spine and stress joints
are most often affected. Muscle spasms,
pain, swelling, and deformity are associated
TREATMENTThe treatment consists of
rest (complete bed rest in severe episodes),
proper diet, analgesics, and anti-inflammatory
drugs. Aspirin, for those who can tolerate it, is
the drug of choice since it possesses both
analgesic and anti-inflammatory properties and
is relatively safe. Moist heat, reduction of weight
(specifically in degenerative arthritis) and corti-
costeroid injections may be indicated. Evacuate
the patient for evaluation.
This is a form of arthritis primarily affecting
the great toe, ankles, and thumbs. It is caused by
collections of urate crystals in the tissues and may
SYMPTOMSDeformities, redness, pain,
and swelling of tissues around the joints are
common. Often this disease resembles cellulitis.
TREATMENTIndocin® is indicated for
acute attacks. Corticosteroids are contraindicated.
Recurrent attacks may be prevented by using
Zyloprim®. Moist heat and analgesics are
indicated for symptomatic treatment.
This acute arthritis results from systemic
infection with gonococcus. It usually occurs in the
large hinge joints.
SYMPTOMSRedness, swelling, severe pain,
fever, and limitation of movement and markedly
increased pain upon movement are common.
TREATMENTTreatment is aimed at
preventing destruction of the affected joints. This
destruction occurs in a relatively short period.
Penicillin or other antibiotic therapy is definitive.
Other treatment is symptomatic.
In all cases of severe or chronic arthritis, refer
the patient to a rheumatologist for further
DISORDERS OF THE EAR,
NOSE, AND THROAT
The following are some of the more common
disorders of the ear, nose, and throat that you
will encounter when conducting sick call:
Conditions of the Ear
Loss of hearing may result from trauma,
tumors, infections, impacted cerumen, excessive
noise, or as a result of a degenerative nerve
SYMPTOMSTinnitus, decreased hearing
ability, and in some cases, pain are common.