Clinical Approach to Degenerative Joint Disease and Osteoarthritis (Johnston)

Question 1

With osteoarthritis (OA), what aggravates the pain and what alleviates it?

Answer 1

Pain worse with activity and is alleviated with rest

Question 2

In the pathophysiology of OA, what inflammatory cytokines drive tissue destruction?

Answer 2

IL-1B and TNF

Question 3

What are some characteristics of OA?

Answer 3

1) Loss of cartilage
2) Subchondral bone thickening
3) Marginal spurs (Osteophytes)

Question 4

OA usually affects what joints?

Answer 4

1) Weight bearing joints (hips, knee)

2) Frequently used joints (hands)

Question 5

What are the Heberden’s and Bouchard nodes seen with OA?

Answer 5

Bony enlargement of DIP and PIP joints

Question 6

The hip involvement of OA manifests as?

Answer 6

Groin pain

Question 7

OA of spine can lead to?

Answer 7

Spinal stenosis

Question 8

What joints are commonly affected by primary OA?

Answer 8

1) Hip
2) Knee
3) DIP and PIP
4) 1st MTP and 1st CMC
5) C and L spine

Question 9

What joints are commonly affected by erosive OA?

Which sex is it more common in?

What appearance does it have on imaging?

Answer 9

1) DIP and PIP
2) Women
3) Seagull appearance in finger joints