Arthrosis diagnosis and treatment

Question 1

Whats arthrosis really called

Answer 1

Osteoarthritis

Question 2

Cause and presentation of arthrosis/OA

Answer 2

Caused by mechanical wear and tear of joints
Damage -> inflammation -> inadequate repair

Presents as pain in weight bearing joints. Pain increases with use and decreases with rest.

May be assymmetric, knees most frequently affected, and especially the medial side, causing bow legged stance

Most importantly there are NO systemic symptoms.

Question 3

Risk factors for OA

Answer 3

Age, female sex, obesity, joint trauma

Question 4

Joint characteristics of arthrosis

Answer 4

LOSS (LOSsSc)
Loss of joint space
Osteophyte growth (bone spurs)
Subarticular Sclerosis
Subchondral Cysts

Synovial fluid is NOT inflammatory, WBC count less than 2000/mm2

Question 5

Hand characteristics of OA/Arthrosis

Answer 5

Heberden nodes and Bouchard nodes

Involve the thumb carpo-metacarpal joint (at wrist)
Involve both interphalangeal joints, distal and proximal

Heberden nodes - DIP joint
Bouchard nodes - PIP joint

Question 6

Treatment of OA

Answer 6

Core treatment is PHYSICAL THERAPY/EXERCISE and strengthening of the muscles around the joint.

Drug treatmentL
Acetominophen - OA is the only one where acetominophen is a major treatment

Topical NSAIDs:

Intra-articular glucocorticoid injections

Codeine and NSAIDs for pain management.

Joint replacement in severe cases.