L06: Osteoarthritis And Septic Arthritis Flashcards

1
Q

What is osteoarthritis

A

Non inflammatory condition characterised by the destruction of articular cartilage and formation of new bone

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2
Q

What type of joints does osteoarthritis commonly affect

A

Large joints e.g hip, knee, spine

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3
Q

What are the risk factors for osteoarthritis

A
Poor posture
Obesity 
Joint intensive sports
Occupation
Previous injury to a joint
Family history 
Age and gender
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4
Q

What is the presentation of osteoarthritis

A

Joint pain
Swelling
Stiffness
Only one or 2 joint involved

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5
Q

When is the pain worse in osteoarthritis

A

On movement and is worse with rest

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6
Q

What are the features of osteoarthritis on large joints on x-ray

A
Narrowed joint space
Subchondral sclerosis
Synchondral cysts
Osteophytes
Intra articular loose bone
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7
Q

What are the features of a small joint osteoarthritis on x-ray

A
Joint space narrowing
Subchondral sclerosis
Subchondral cysts
Osteophytes
Haberdens nodes  
Bouchard nodes
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8
Q

What is a haberdens nodes

A

Swelling of DIPJ

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9
Q

What is a Bouchard node

A

Swelling of PIPJ

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10
Q

What are the differences of osteoarthritis and rheumatoid arthritis

A
Osteoarthritis:
Pain worse with exercise 
Morning stiffness lasts 30-60mins
Over the age of 50
Bouchard and haberdens nodes
Rheumatoid arthritis:
Pain worse with rest 
Morning stiffness lasts more than 1 hour
Pain improves with movement 
Age between 20-40
Heberdens nodes is absent due to DIPJ sparing 
General systemically unwell
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11
Q

What are the x-ray features of ra

A
Sparing of DIPJ (no haberdens nodes)
Peri articular erosions
Bone erosion
Subluxation
Deformity (swan neck and boutonnière)
Ulnar deviation
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12
Q

What is the management of osteoarthritis

A

Conservative: weight loss, exercise, physiotherapy
Pharmacological: analgesia, corticosteroid injection to the joint
Surgical: resurfacing the joint, osteotomy and joint replacement

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13
Q

What is septic arthritis

A

Infection of a joint caused by pathogen inoculation

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14
Q

How can bacteria enter the joint

A

Wounds
Surgical incision
Blood stream

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15
Q

Which common organism is likely to cause septic arthritis

A

Staphylococcus aureus

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16
Q

What is the presentation of septic arthritis

A

Pain
Septic
Fever

17
Q

On examination how does the joint appear in septic arthritis

A
Red
Swollen
Warm
Tender
Inability to weight bear 
Inability to tolerate passive movement 
Extremity held in position to maximum joint volume
18
Q

What are the investigations carried out in septic arthritis

A

FBC: white blood ell count, CRP and serum uric acid

19
Q

What does a raised white cell count, high CRP and normal uric acid suggest

A

Infective joint

20
Q

What does a normal white cell count, high CRP and high uric acid acid suggest

A

Gout

21
Q

What other investigations can be carried out

A

Joint aspirate for: appearance, microscopy, culture, crystal analysis

22
Q

What is the management of septic arthritis

A

Intravenous antibiotic therapy

Surgical (gold standard): washing joint and then commencing antibiotic therapy