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CONDITION/DISORDER SYNONYM

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  • Lupus erythematosus

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ICD-9-CM CODES

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  • 695.4 Lupus erythematosus

  • PT diagnoses/treatment diagnoses that may be associated with immune disorders affecting movement

    • 315.4 Developmental coordination disorder

    • 718.07 Articular cartilage disorder, ankle and foot

    • 718.03 Articular cartilage disorder, forearm

    • 718.04 Articular cartilage disorder, hand

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.39 Palindromic rheumatism involving multiple sites

    • 719.4 Pain in joint

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 729.9 Other and unspecified disorders of soft tissue

    • 729.1 Myalgia and myositis, unspecified

    • 729.9 Other disorders of soft tissue

    • 736.9 Acquired deformity of limb site unspecified

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODES

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  • L93.0 Discoid lupus erythematosus

  • L93.2 Other local lupus erythematosus

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PREFERRED PRACTICE PATTERNS1

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  • 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissues Dysfunction

  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation

  • 7B: Impaired Integumentary Integrity Associated with Superficial Skin Involvement

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PATIENT PRESENTATION

A 28-year-old Asian female is referred to physical therapy6 months postpartum with her first child. Since the baby’s birth, she has been suffering from what she describes as severe fatigue with muscle weakness and pain in her legs and hands, making it difficult to take care of her baby. She also has some mild back pain. She is upset because her husband thinks she is just depressed. Her history reveals that during her last trimester she complained of a rash on her face that the obstetrician told her was a “rash of pregnancy” and not anything to worry about. A mild rash is evident on her cheeks at the time of her initial PT evaluation. Throughout the initial examination she is drinking water because her mouth is dry and she is also complaining of dry eyes.

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FIGURE 49-1

Systemic lupus erythematosus: butterfly rash associated with pericardial, myocardial, and endocardial disease. (From Fuster V, Walsh RA, Harrington RA. Hurst’s The Heart, 13th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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KEY FEATURES

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Description
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  • A long term autoimmune disease that attacks the body’s tissues and organ systems as if they were foreign substances.

  • Affects skin, joints, kidneys, brain, and other organs.

  • Although systemic lupus erythematosus (SLE) is a most common form, there are others: Discoid or cutaneous lupus, drug-induced systemic lupus, neonatal lupus, and subacute cutaneous lupus.

  • Onset often vague with misdiagnosis.

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Essentials of Diagnosis
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  • Must be made by a physician and confirmed by medical diagnostic testing

  • According to the American College ...

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