Degenerative bone disorders Flashcards
Which sex has the greatest incidence of OA? [1]
Female
State 5 risk factors for OA
Abnormal mechanical loading (e.g. damaged menisci) changes the biomechanics of the joint
Inherited type two collagen defects
Obesity
Inheritance (in nodal and erosive OA)
Occupation (farmers: OA hip)
Age > 50
Where does the Q angle run from? [3]
Two lines:
ASIS (Anterior superior iliac spine) to center of patella
Tibial tuberosity to the center of the patella
What is normal Q angle? [1]
15 - 20 degrees
Why are women more likely to get OA due to their Q angle? [1]
Bigger Q angle: more weight is directed to medial side of knee
(men put weight more centrally so is equally distributed)
Why is exercise good in improving or slowing progression of OA? [2]
Name two risks for a weak gluteus medius [2]
Weak gluteal: hip not stabilised
Weak quadriceps: knee not stabilised
Weakness of gluteus medius linked to gender and obesity
What are the three most common co-morbids. [3]
CVD
Cardiometabolic
Mental health
What type of diet is recommended for OA? [1]
Mediterranean: Anti-inflammatory diet
Why does obesity nutritionally increase the risk of OA? [1]
Poor diet may result in lack of protective nutrients and increase amounts of proinflammatory substances
Increases stress on joints and chondrocytes
Increases adipose derived inflammatory mediators
What are the three subsets of primary OA? [3]
Idiopathic
Generalised
Erosive
What are the five subsets of secondary OA? [5]
Mechanical incongruity of joint, congenital or acquired
Due to prior inflam. disease (RA)
Due to endocrine disorders (e.g. diabetes)
Due to metabolic disorders
Misc. (e.g. avascular necrosis)
What are the 4 signs of OA? [4]
Cartilage loss:
* joint space narrowing
Bone response:
* osteophytes
* subchondral sclerosis
* trabeculae fractures/subchondral cysts
OA diagnosis
What type of imaging would you use to ID OA in the past? [1]
Radiographs
What type of imaging would you use to ID OA in present? [3]
MRI
Arthroscopy
Ultrasound
Make qs on different images / signs of OA on imagin / radiographic signs of OA - e.g. spot
Which joint is damaged by OA? [1]
The US examination revealed the following: on the right hip joint (left image), the contour of the femoral head is uneven and deformed, cartilage visualization is unclear and the joint capsule is thickened.
The left hip joint (right image) showed the following: the contour of the femoral head is even, cartilage surface is smooth, homogeneous, joint capsule is normal
imaging slide
Describe the different grades of OA [4]
Grade 0
* Normal
Grade 1
* Very minor bone spur no pain or discomfort (wouldn’t know that have OA)
Grade 2
* 1st time people experience symptoms, pain on walking more bone spurs
Grade 3
* Moderate OA with frequent pain and joint stiffness especially after rest, cartilage shows damage
Grade 4
* Severe OA with dramatic loss of joint space high levels of pain and discomfort during walking or moving joint
What are the two specific types of OA that effect the hands?
Nodal generalised OA
Erosive OA
Describe the nodes seen in nodal generalised OA [2]
Nodal generalised OA:
* DIP – Herberden’s node
* PIP – Bouchard’s node
Which type of node is present in this OA patient? [1]
- PIP – Bouchard’s node
Which type of node is present in this OA patient? [1]
Heberden node
Erosive OA is a subset of which type of OA? [1]
nodal generalised OA
Describe the degeneration that occurs in erosive OA [1]
Which population is most effected by erosive OA? [1]
State two disease / pathological states that OA is linked to [2]
Primarily characterized by erosions of cartilagein the DIP and PIP joints
* Middle finger DIP most often affected and more often symmetrical
Middle-aged or post-menopausal women are most commonly affected
Erosive OA may be linked to dyslipidaemia and metabolic syndrome
How does erosive present undering imaging? [1]
Gull-wing or sawtooth
Which inflammatory markers in erosive OA and RA? [2]
DRB101 and DRB107
Explain 7 physical signs of OA
Crepitus
* Grinding / creaking from cracks and loss of articular cartilage
Bony enlargement
* Osteophytes
Deformity
* Osteophytes and loss of articular cartilage
Instability (pseudolaxity)
* Loss of joint space but ligaments are normal length
Restricted movement
* Osteophytes
Effusion (mild)
* Osteophytes irritate synovium and pro-inflammatory cytokines
Muscle weakness or wasting
* Pain restricts / reduces joint use
Label these signs of OA
A: osteophytes
B: tibial spiking
C: irregularity
D: narrowing
What sign is outlined in this patient with OA? [1]
sclerosis
What sign is outlined in this patient with OA? [1]
Osteophytes
What sign is outlined in this patient with OA? [1]
subchondral cysts
