Systemic lupus erythematosus (SLE)

[nathanja]

I,am a student fysio from the netherlands and I would like to know more about a disease Systemic lupus erythematosus SLE that my patient has and someting about the treatment as a fysiotherapist
As soon as possible,
Thank you,
Nathanja

E-mail : [email protected]

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[sven]

Hello,
The joint pain of lupus arthritis often comes and goes. Individual attacks may last several days or weeks and then subside, only to recur at a later date. The joints farthest from the trunk of the body (i.e., fingers, wrists, elbows, knees, ankles) are most frequently involved, usually several at a time. Stiffness and pain in the morning, which improves as the day goes on, is characteristic of lupus arthritis. Later in the day, as the individual becomes more tired, the aches may return. Another characteristic of lupus arthritis is that the pain is usually symmetrical, which means that it affects similar joints on both sides of the body. Therefore, a single, chronically painful and swollen joint, even in a person who has been diagnosed with lupus, is most likely due to some other cause. Backaches or neck pains are not caused by lupus arthritis since the spine is not involved in lupus.
Unlike osteoarthritis, lupus arthritis does not usually cause deformities or destruction of the joints. This lack of damage to the joints is observed both clinically and by x-ray, even after months of joint symptoms.

Treatment.
Lupus arthritis is usually treated with non-steroidal, anti-inflammatory medications (e.g., aspirin, ibuprofen, naproxen). These medications are effective in the majority of cases and are usually well tolerated. However, when this line of therapy is not effective, antimalarial drugs such as hydroxychloroquine (Plaquenil) may be added. Corticosteroids (Prednisone) are used rarely and only when the joints remain swollen and painful despite other treatment. Cytotoxic medications should not be used to treat only lupus arthritis. It is also important that a person learn joint protection procedures to be able to rest his or her joints during flares of lupus arthritis.
Lupus Myositis Unlike the joints, the muscles can be seriously damaged by SLE. This damage may result in muscle weakness and loss of strength unless early, appropriate treatment is given. Inflamed muscles may not only be painful, but may also be tender to the touch. Muscle weakness is the most common symptom of lupus myositis.
Characteristically, the muscles of the trunk of the body are affected (i.e., neck, pelvic girdle and thighs, shoulder girdle and upper arms). Pain in the small muscles of the hand or weakness of the grip are not symptoms of SLE myositis. However, nerves as well as muscle fibers can be caught up in the inflammatory process and, occasionally, weakness of the wrists and hands or the ankles and feet may occur as a result of nerve damage. A regular, well-designed exercise program is important to help prevent muscle weakness in people with lupus myositis.
They are also at risk of osteoporosis!
Hopefully this will help a bit. Could't find anything on physio
Sven

[perfphysio]

One classic feature is the "Butterfly Rash", a rash on the face across the nose and cheeks that looks like a butterfly. I remember it well because like all good physio students, I thought I diagnosed myself with SLE during a lecture!

[dailyPT]

Is it safe to apply hot moist pack on elbow of patient with SLE + DVT? Although I'm sure that SLE is only contraindicated to UVR.

[physiobob]

I do not think that this is contraindicated providing the DVT is not in the arm and is in the leg. As for the results it would be a little more of the try and see what effect it has. Always follow the normal precautions and special tests before administering a heat related treatment intervention.

[dailyPT]

I've tried it earlier and bright red non itchy rashes appeared after 15 minutes. I told it to the doctor and when she inspected it, the rash already subsided. She just said it is a normal response to heat. (>_<)