Johnston: OA and DJD

Question 1

Prevalence of OA is increasing due to what 2 factors?

Answer 1

Obesity and Aging populations

Question 2

Synovial inflammation with hypertrophy and effusion is seen with what?

Answer 2

Osteoarthritis

Question 3

Which joints most often affected in OA?

Answer 3

• Weight bearing joints and frequently used joints
• Hips, knees, spine
• Hands: DIP, PIP, and 1st CMC - thumb base

Question 4

Hip involvement in OA most commonly manifests as what sx?

Answer 4

Groin pain

Question 5

What is the Erosive subtype of OA; seen most often in whom?

Answer 5

• Affects DIP and PIP joints; more painful than typical hand OA
• More common in women

Question 6

What is commonly seen on radiographs in pt with Erosive OA and how can it be differentiated from RA?

Answer 6

Central erosions (vs. marginal erosions in RA) w/ “seagull” appearance in finger joints

Question 7

Which underlying GI disease can lead to secondary OA; which joints most often affected?

Answer 7

• Hemochromatosis
• 2nd/3rd MCP joints and wrist

Question 8

Which endocrine abnormality can manifest as secondary OA; which joints most often affected?

Answer 8

• Hyperparathyroidism
• Wrist, MCP

Question 9

What is seen with diffuse idiopathic skeletal hyperostosis (DISH); what are the criteria?

Answer 9

• Calcification and ossification of spinal ligaments i.e., anterior longitudinal ligament and enthesis (tendon/lig. attachement to bone)
• No SI joints involvement*
• Ossifications of at least 4 contiguous vertebral levels, usually on the right side of spine

Question 10

What are the non-pharmacologic appraoches to tx OA?

Answer 10

• Education on OA and joint protection
• Weight loss
• Proper footwear + cane + bracing
• Isometric - aerobic exercise + strength training