Joint Disorders - Osteoarthritis Flashcards
OA
Osteoarthritis
What may OA also be called?
degenerative
‘wear and tear’
joint disease
Pathophysiology OA:
- articular cartilage damaged, lost through structural fissures and erosion - excessive mechanical stress/ break down
- surface cartilage = rough/worn interfering w easy movement joint
- tissue damage appears = release enzymes from cells - accelerating disintegration of cartilage
4.eventually subchondral bone exposed
cysts and osteophytes or new boner spurs develop around margin of bone
- pieces of osteophytes and cartilage break off into synovial cavity - further irritation
- joint space becomes narrower (seen Xrays)
- may be secondary inflammation surrounding tissues in response to altered movement and stress on joint.
No systemic effects present with OA
What is the primary form of OA associated with?
Obesity
Ageing
What is the secondary form of OA associated with?
follows Injury or Abuse
What research into changes have been identified in Joint Cartilage that is currently underway?
What do these changes result in?
Genetic Changes
Accelerated breakdown of articular cartilage
Why does OA often develop in specific joints?
injury
excessive wear and tear
common consequence participation in sport and certain occupations
What may congenital anomalies of the MSK predispose patients to?
OA
Once the cartilage is damaged what happens?
What vicious cycle does this then result in?
joint alignment or frictionless surface of articular cartilage is lost
viscous cycle ensues as uneven, mechanical stress applied to other parts of the joint and to other joints
what joints are frequently affected by OA?
large weight-bearing joints (knees, hips)
subject to injury occupational stress
Explain Pain in OA:
often mild, insidious initially
aching occurs on weight-bearing and movement
more severe as the degenerative process advances
may be unilateral in some cases
Signs and Symptoms OAP:
Pain
Limited Join Movement
Joint Appears Enlarged
Muscle Atrophy
Explain Limited Join Movement in OA:
the joint appears large and hard
walking becomes difficult if the joint is unstable and the muscles atrophy causing predisposition to falls esp in older individuals
Explain Joint Appearance in OA:
the joint appears enlarged and hard as osteophytes develop
What happens when the Tempromandiubar joint becomes involved in OA?
mastication difficulty
difficult opening mouth to speak or yawn
preauricular pain may be severe
Preauricular
..
Subchondral bone
..
What happens when in some cases where hands become involved in OA?
bony enlargement of distal interphalangeal joints (Herbenden nodes)
usually, little soft tissue swelling is seen
What is Crepitus heard in OA?
cartilages become irregular grating against each other
Why are other joints sometimes affected in OA?
individual exerts more stress on normal joints to protect the damaged joints
Why are there no systemic signs or changes in serum levels in OA?
it is not a systemic disorder
What is Dx of OA based on?
exclusion of other disorders
radiographic evidence of joint change consistent with clinical signs
radiographic often shows less progression of joint changes that the clinical effects
Treatment for OA:
undue stress - minimised
adequate rest
an additional support to aid movement
ambulator aids - canes, walkers - helpful
orthotic insert - reduce deformity, help maintain function
physiotherapy/massage therapy - reduce spasm adjacent muscle pain = maintain joint function and strength
occupational therapy -assistive devices (splint) teaching alternative practices reduce pain deal stiffness
intraarticular injections synthetic synovial fluid - reduce pain facilitate movement
analgesia, NSAIDs
Surgery repair or replace - e.g. knee or hip prosthesis
What treatment mat individuals with early OA take?
may find pain relief, improved flexibility with use glucosamien-chondroitin compound
What does the success of arthroplasty depend on?
full participation rehabilitation programme following surgery
