5010 - Post-traumtic arthritis

DBQ: Link to Index of DBQ/Exams by Disability for DC 5010 

Definition

Traumatic arthritis is defined as an inflammation of a joint resulting from a forceful injury. (See Diagnostic Code: 5003 Arthritis, degenerative, other than post-traumatic)

Etiology

The cause of the condition may be due to an acute injury due to excessive, forceful pressure such as an injury in service resulting in a fractured bone or an endotracheal intubation which may lead to arthritis of the temporomandibular joint (TMJ).

Signs & Symptoms

Signs and symptoms of the condition include pain, tenderness, and limitation of motion.

Tests

X-rays are done. The results may occasionally show a widened joint space of the TMJ caused by edema and severe hemorrhage.

Treatment

Treatment for the condition includes nonsteroidal anti-inflammatory drugs (NSAIDs), application of heat, a soft diet, and restriction of jaw movement.

Residuals

Residual may vary from limited movement of the jaw or the affected joint to no residuals.

Special Considerations

  • The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

  • Rate as limitation of motion, dislocation, or other specified instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with § 4.25.

  • If etiology of arthritis is traumatic, evaluate under Diagnostic Code 5010.

  • When rating severity of arthritis, the shoulders, elbows, wrists, hips, knees, and ankles are considered major joints.

  • When rating severity of arthritis, multiple involvement of the interphalangeal, metacarpal, and carpal (wrist) joints; interphalangeal, metatarsal, and tarsal joints; and cervical vertebrae, thoracic/dorsal vertebrae, and lumbar vertebrae are considered minor joints or joint groups, ratable as major joints.

  • When rating severity of arthritis, occasional incapacitating increases of pain in degenerative arthritis are generally considered to be occurrences that cause the individual to lose actual workdays on at least a few times within a year.

  • When assigning a Diagnostic Code or rating arthritis severity, a limitation of motion of a joint due to degenerative arthritis or arthritis due to trauma should be rated under limitation of motion rather than degenerative arthritis if it is more advantageous to the Veteran (e.g., degenerative arthritis of both shoulders with right (major) arm motion limited to 25 degrees, rate under "Arm, limitation of motion - 40%" vice Degenerative Arthritis - 10 or 20%).

  • To properly rate disability of arthritis, examinations should address the Veteran's carriage, posture, and gait.

  • To properly rate disability of arthritis, accurate measurements of joint movement limitations are required and must be reported in degrees. The use of a goniometer (device for measuring joint movements and angles) in the measurement of range of motion in a joint is indispensable. 38 CFR 4.46 [Accurate measurement]. To properly rate disability of arthritis it is important to understand the range of motion chart Plate I & II, 38 CFR 4.71 [Measurement of ankylosis and joint motion].

  • The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. See 38 CFR 3.307(a)(3)  [chronic disease].

  • If a Veteran is a former prisoner of war, this disease shall be service connected if manifest to a degree of disability of 10 percent or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309(c) Disease subject to presumptive service connection].

  • May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

Notes

  • None.