Joint Disorders - Osteoarthritis

Question 1

OA

Answer 1

Osteoarthritis

Question 2

What may OA also be called?

Answer 2

degenerative
‘wear and tear’
joint disease

Question 3

Pathophysiology OA:

Answer 3

1. articular cartilage damaged, lost through structural fissures and erosion - excessive mechanical stress/ break down
2. surface cartilage = rough/worn interfering w easy movement joint
3. 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

5. pieces of osteophytes and cartilage break off into synovial cavity - further irritation
6. joint space becomes narrower (seen Xrays)
7. may be secondary inflammation surrounding tissues in response to altered movement and stress on joint.
   No systemic effects present with OA

Question 4

What is the primary form of OA associated with?

Answer 4

Obesity

Ageing

Question 5

What is the secondary form of OA associated with?

Answer 5

follows Injury or Abuse

Question 6

What research into changes have been identified in Joint Cartilage that is currently underway?
What do these changes result in?

Answer 6

Genetic Changes

Accelerated breakdown of articular cartilage

Question 7

Why does OA often develop in specific joints?

Answer 7

injury
excessive wear and tear
common consequence participation in sport and certain occupations

Question 8

What may congenital anomalies of the MSK predispose patients to?

Answer 8

OA

Question 9

Once the cartilage is damaged what happens?

What vicious cycle does this then result in?

Answer 9

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

Question 10

what joints are frequently affected by OA?

Answer 10

large weight-bearing joints (knees, hips)

subject to injury occupational stress

Question 11

Explain Pain in OA:

Answer 11

often mild, insidious initially
aching occurs on weight-bearing and movement
more severe as the degenerative process advances
may be unilateral in some cases

Question 12

Signs and Symptoms OAP:

Answer 12

Pain
Limited Join Movement
Joint Appears Enlarged
Muscle Atrophy

Question 13

Explain Limited Join Movement in OA:

Answer 13

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

Question 14

Explain Joint Appearance in OA:

Answer 14

the joint appears enlarged and hard as osteophytes develop

Question 15

What happens when the Tempromandiubar joint becomes involved in OA?

Answer 15

mastication difficulty
difficult opening mouth to speak or yawn
preauricular pain may be severe

Question 16

Preauricular

Answer 16

..

Question 17

Subchondral bone

Answer 17

..

Question 18

What happens when in some cases where hands become involved in OA?

Answer 18

bony enlargement of distal interphalangeal joints (Herbenden nodes)
usually, little soft tissue swelling is seen

Question 19

What is Crepitus heard in OA?

Answer 19

cartilages become irregular grating against each other

Question 20

Why are other joints sometimes affected in OA?

Answer 20

individual exerts more stress on normal joints to protect the damaged joints

Question 21

Why are there no systemic signs or changes in serum levels in OA?

Answer 21

it is not a systemic disorder

Question 22

What is Dx of OA based on?

Answer 22

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

Question 23

Treatment for OA:

Answer 23

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

Question 24

What treatment mat individuals with early OA take?

Answer 24

may find pain relief, improved flexibility with use glucosamien-chondroitin compound

Question 25

What does the success of arthroplasty depend on?

Answer 25

full participation rehabilitation programme following surgery