1 Flashcards
Osteoarthritis
most common arthritis 1 million ppl seeing gp per year 115000 hospital admissions can be degenerative or wear and tear non-inflammatory disease
summary
deterioration of articular cartilage in synovial joint or fibrocartilage in interverbral disc
cartilage softens thins and wears away exposing bone forming bony spurs-osteophytes
synovium thickens and causes joint swelling secondary inflammatory changes
the capsule slowly thickens and contracts
most commonly weight bearing joint
destructive and productive
prevalance
diarthrodial joints
elderly
females more than males
weather
cause
abnormal joint deterioration with normal use
or
normal joint detriotiating when exposed to abnornal stresses
contributing factors
othopaedic factor overuse-high impact orrepetivive strain previous disease or injury hereditary factor obesity age
primary OA
no obvious cause
increases with age
localised
secondary OA
Follows demonstrable abnormality Localised Repetitive Strain Metabolic disease Previous Disease Endemic
articular cartilage
abnormal mechanical stress
increased bone stiffnes
chondrocyte dysfunction
oedermatous soft cartilage
changes cartilage
- chondrocytes release enzymes and chemicals which breakdown collagen fibres
- proteoglycan break down bringing in more water
- h2o content increase
- disruption of chondromucoprotein
- decrease width of collagen fibres
- less proteoglycans
- cartilage become soft and oedematous
- secondary damage to chondrocytes no cartilage produced
- further matrix breakdown
- increased stress on collagen network
- softening & splitting of cartilage surface
- fibrillation of cartilage
subarticular bone
thickens and harderns cracks cysts eburnation osteophytes
synovial membrance and capsule
inflammtion
fibrosis
contraction
features
pain deformity stiffness Decreased ROM Decreased ADL Muscle wastage crepitus-friction
depression
Hip
Pain altered gait pattern deformity limited ROM limited ADL
Knee
Pain altered gait pattern deformity limited ROM limited ADL crepitus-friction muscle wasting
commonly affected
DIP PIP
midtarsal
spine-cervical, thoraic and lumbar
TMJ
