3. Osteoarthritis Flashcards
Structure of normal joint
- synovial membrane
- synovial fluid
- periarticular soft tissue
- subchondral bone
- articulate cartilage
Articulate cartilage
Chondrocytes
Synthesis of ECM! (Collagen, proteoglycans)
Degradation of ECM
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Collagen in joint
Proteoglycans in articulate cartilage
If osteoarthritis -> decreased water binding capacity
Hyaluronan in articulate cartilage
Structure of joint capsule
Definition of osteoarthritis
Pathogenesis of osteoarthritis
Molecular pathogenesis of osteoarthritis
Normal joint vs joint with osteoarthritis
Pathogenesis
Abnormal forces on joint surface as cause of OA
Angular/flexor deformities
Disturbance in cartilage development as a cause of OA
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Clinical signs of osteoarthritis
- joint effusion increased
- lameness
- decreased range of motion
- changes in synovial parameters (microscopically and lab parameters)
- cartilage damage
- new bone formation (osteophytes)
Lameness examination in diagnosis of OA
Arthrocentesis — ?
Diagnostic imaging in case of OA
Mainly radiography
Radiographed changes in OA
Synovial fluid analysis. What parameters are checked?
First microscopically (in OA viscosity will decrease)
- Leukocytes (cell/microliter)
- Neutrophil (%)
- TP (g/dl)
Treatment of OA
NSAIDs in OA
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Phenylbutazone
iv, po. SE: gastric ulceration, right dorsal colitis, papillary necrosis. **Cheap, can be used by owner (po)
flunixin-meglumine
iv, po. Analgesic effect mainly for soft tissues, postoperative care
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Corticosteroids in OA. General info
- ia application
Corticosteroids in OA. Drugs
Hyaluronate sodium in OA
PSGAG
IRAP
Biphosphonates ?
Intraart icular polyacrylamide hydrogels
Stem cells in OA
Supplements in OA
Surgical treatment of OA
Chondroplasty
Bone spavin