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Instructions: Please make sure that your response to the classmate has substance. That means at least 2-3 paragraphs in length, bringing something NEW to the table and that you used at least one (1) primary reference. This reference must be DIFFERENT from the one you used in your own initial post.
Just a reminder that the primary reference is a peer reviewed article from a professional journal (not necessarily OT journal!), and it should not be older than 5 years. You can additionally support your claims with textbook/s and/or other publications (from websites ending with “.gov” or similar (NEVER ending with “.com”!). Please remember that published documents, procedures, policies, and so forth also can be used, but ONLY as SUPPORTIVE references, never primary ones.
Classmate discussion is the following:
Palindromic rheumatism (PR) is a rare type of arthritis often confused for rheumatoid arthritis as they have common symptoms and characteristics. One key difference is that palindromic rheumatism does not cause permanent joint damage, whereas rheumatoid arthritis can lead to chronic joint deformities over time. PR episodes typically occur suddenly and resolve within a few days. Palindromic rheumatism affects the shoulder, fingers (MCPs and PIPs), wrist, and knee joints. The symptoms include joint pain, swelling, and erythema, which are manageable with anti-inflammatory and antimalarial drugs (Mankia & Emery, 2019). Additionally, PR does not always progress to a chronic condition like rheumatoid arthritis, and patients may experience long periods of remission.
As previously stated, PR does not cause permanent damage to the joints. However, people who experience frequent flare-ups may experience fatigue, which can lead to a decline in occupational performance. Individuals with PR may find it challenging to engage in tasks that require fine motor skills, such as typing or sewing, due to joint pain and swelling in their fingers and wrists. Physical activities, like lifting or carrying heavy objects, may also be difficult because of the potential discomfort in the shoulders and knees. Additionally, managing daily routines such as dressing or cooking can become burdensome during flare-ups, impacting overall quality of life. (Institute for Quality and Efficiency in Health Care (IQWiG), 2024). This discussion post will highlight some areas of occupational performance that are affected by palindromic rheumatism (PR).
1) Palindromic rheumatism and performance patterns:
Motor skills: Motor skills are affected as patients with PR experience pain and stiffness in the joints that affect lifting, moving, and transporting heavy objects from one place to another due to swelling and pain in the metacarpal joints. PR can affect grip strength and fine manipulation.
Social interaction skills: One of the symptoms of PR is fatigue. Fatigue can make it difficult for individuals with PR to participate in social activities, as they may feel too exhausted to engage with others. This can lead to reduced social interactions and a sense of isolation. Over time, this can affect their relationships and emotional well-being, as maintaining social interactions becomes more challenging.
2) Performance Patterns: PR can affect habits, routines, and roles. Some examples include:
Habits: If the patients diagnosed with frequent flare ups of PR have a habit of carrying heavy loads, texting, and meal prepping in a specific way that can irritate the joints, these habits will affect their daily lives.
Routine: PR can affect patients’ routines when performing activities such as bathing, toileting, and grooming during flare-ups, as patients will experience pain and stiffness in the shoulder, wrist, and finger joints. To perform these self-care tasks, patients will use excessive joint movements that could impact occupational performance.
Roles: PR can affect patients who have jobs that require high physical demand and frequent repetitive movements. Surgeon, construction worker, waitress, mechanic, secretary, etc. are roles that may be affected by PR.
3) Activity demands: Patients with PR are affected in many areas of their occupation. Several activity demands are required to complete specific tasks, such as the amount of force needed to grip an object, endurance to complete a task without getting fatigued, attention, and fine motor skills to complete specific tasks.
4) Palindromic rheumatism and client factors:
· Specific mental function: Patients diagnosed with PR experience a range of emotions, including anger, frustration, anxiety, fear, irritability, stress, guilt, shame, etc.
5) Context: The personal and physical context patients with PR are also affected. If they are living alone, they are obligated to cook, do laundry, and do other activities, which can add lots of pressure to the joints. Patients who work in restaurants will require accommodation. (American Occupational Therapy Association, 2020)
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