Degenerative conditions OA Flashcards

1
Q

what is sarcopenia

A

the loss of skeletal muscle mass and strength as a result of ageing.

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2
Q

how much muscle mass do you loose between the ages of 30-80

A

Normal individuals exhibit an approx. 30% decrease in total muscle mass (sarcopenia) between the ages of 30 to 80 years.

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3
Q

what is the cause of sarcopenia

A

low sex hormones

low IGF-1 levels

decrease in activity

osteoarthritis and neuronal degeneration

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4
Q

describe how much muscle mass you loose per decade after the age of 30

A

3% to 5% of muscle mass lost per decade after age 30

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5
Q

what does loss of muscle mass lead to

A

Leads to camptocormia,

frailty and falls

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6
Q

what are the three reasons for loss of height with age

A

1, disc degeneration
2, sarcopenia and camptocormia
3, osteoporosis and vertebral collapse

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7
Q

how do you prevent and treat sarcopenia

A
  • Exercise
  • vitamin D repletion
  • HRT if menopause is premature
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8
Q

What is spondylosis

A

Degenerative condition of discal articulation of the spine.

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9
Q

describe what an osteoarthritis radiography looks like

A
  • evidence of cartilage loss - joint space narrowing

- evidence of bone response (presence of osteophytes and sclerosis)

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10
Q

what are risk factors for osteoarthritis

A

Obesity especially OA knee

Abnormal mechanical loading eg menisectomy, instability and dysplasia

Inherited type II collagen in premature polyarticular OA

Inheritance in nodal OA

Occupation eg farmers & OA hip

Non-gonococcal septic arthritis

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11
Q

what are herberdens nodes

A

Heberden’s nodes are bony swellings of the DIP joint or distal interphalangeal join

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12
Q

What are bouchards nodes

A

Bouchard’s nodes are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints (the middle joints of fingers or toes

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13
Q

Name nodal generalised OA

A

Heberden’s nodes

Bouchard’s nodes

CMC of thumb

Hallux valgus/rigidus

Knees & hips

Apophyseal joints- synovial joints at the back of the spine

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14
Q

What is Hallux valgus

A

Hallux valgus is a deformity of the first metatarsophalangeal joint

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15
Q

what is crystal associated OA

A
  • this is when there is calcium deposition within the cartilage
  • calcium pyrophosphate dehydrate occurs mainly in elderly women and affects the knee principally
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16
Q

what is crystal associated OA associated with

A

hips and shoulders and knees of elderly women

- often has a poor outcome

17
Q

what can cause OA of premature onset

A

Previous menisectomy

Haemochromatosis

18
Q

What are the physical signs in OA

A

Crepitus

Bony enlargement

Deformity

Instability

Restricted movement

Effusion

Muscle weakness or wasting

19
Q

name an exercise that you can do for OA of the knee

A
  • Quadriceps building exercises for OA of the knee
  • rise it up
  • count from 1-10 and put it down
  • this reduces the risk of falling
20
Q

how many people does osteoporosis affect

A

affects an estimated 75 million people in Europe, the US, and Japan; this figure is projected to double over the next 50 years1

21
Q

how many people experience an osteoporotic fracture

A

1 in 2 women and 1 in 5 men over the age of 50 worldwide will experience an osteoporotic fracture

22
Q

what does an osteoporotic spine look like

A

it is kyphotic

23
Q

describe the fracture cascade

A
  • in patients who have already have a fracture there is an increased risk of 86% of sustaining another fracture
24
Q

what is the three types of osteoporosis

A

Type I (postmenopausal)

Type II (senile)

Idiopathic(at ages <50

25
as you increase in age what fractures become higher
- vertebrae and hip increase in prevalence | - colles increases but more or less stays stable
26
how many women have vertebral fractures
Vertebral fractures affect 20 % of women. | Most vertebral fractures are asymptomatic.
27
how many women are affected by hip fractures
Hip fractures affect 25 % of women living to the age 85.
28
what are the clinical consequences of osteoporosis
Increased mortality- 20% in the first year after a hip fracture Pain-early after fracture, prolonged pain due to secondary OA,costal margin impingement Deformities-kyphosis,loss of height,abdominal protrusion Loss of independence
29
How can we prevent osteoporosis
☻Ensure an adequate calcium intake which meets the relevant dietary recommendations in the country or region where they live ☻Avoid undernutrition and protein malnutrition ☻Maintain an adequate supply of vitamin D through sufficient exposure to the sun and through diet ☻Participate in regular physical activity ☻Avoid smoking ☻Be educated about the risk of high alcohol consumption
30
how can you optimise peak bone mass
Exercise- regular and weight-bearing Dietary Calcium-especially during growth
31
How do you reduce the rate of bone loss
Regular exercise Maintain calcium intake Moderate alcohol intake Stop smoking HRT in selective cases
32
what other measures can you use to protect against osteoporosis
Prevention of falls Hip protectors Patient’s education
33
Name the treatment of osteoporosis
Bisphosphonates- etidronate, alendronate, risedronate, ibandronate, pamidronate and zoledronate Selective oestrogen receptor modulators –raloxifene HRT in selective cases Vitamin D & Calcium Teriparatide in severe unresponsive cases (bone forming) Denosumab