Exam 4 - Osteoarthritis Flashcards
What are risk factors for osteoarthritis? (6)
obesity, sex (<45 more common in men), occupation, certain sports (professional-level), Hx of joint injury/surgery, genetics (non-Whites)
List characteristics of osteoarthritis? (5)
> 50 years, gradual onset, unilateral localized to larger weight-bearing joints, <30 min pain associated with use, no autoantibodies
What are strongly-recommended non-pharm treatments for osteoarthritis? (7)
exercise, self-efficacy and self-management programs, weight loss, tai chi, cane, TF knee brace, first CMC orthosis
What are conditionally-recommended non-pharm treatments for osteoarthritis? (3)
CBT, yoga, thermal interventions
What are non-pharm treatments not recommended for osteoarthritis? (3)
TENS, massage therapy, manual therapy with exercise
What are COX-2 selective NSAIDs? (2)
cele/valdecoxib
What risks do COX-2 selective NSAIDs reduce? (2) What do they not affect? (2)
GI toxicity, platelet inhibition; CV and renal effects
Explain the recommendation for oral NSAIDs in osteoarthritis?
recommended in all types
Explain the recommendations for topical NSAIDs in osteoarthritis? (3)
recommended in knee OA, conditionally in hand OA, not recommended in hip OA
Explain the recommendations for IA steroids in osteoarthritis? (2)
strongly recommended in knee and hip OA, conditional in hand
What are contraindications for IA corticosteroid injections in osteoarthritis? (4)
SSTIs, joint infections, unstable coagulopathy, uncontrolled DM
What are conditionally-recommended pharmacological treatments for osteoarthritis? (5)
acetaminophen, tramadol, duloxetine, chondroitin (hand only), topical capsaicin (knee only)
What are pharmacologic treatments not recommended for osteoarthritis? (6)
glucosamine, IA hyaluronic acid, opioids, colchicine, fish oil, vitamin D
What is the dosing for 1% diclofenac gel?
Knee/foot/ankle = 4 g qid, hand/wrist/elbow = 2 g qid
