MSK 01 Flashcards
What is (OA) Osteoarthritis?
Also known as degenerative joint disease.
Osteo means bone & Arthritis means inflammation of joint.
Chronic joint disease leads to immobility & destruction of joints
What are the types of (OA) Osteoarthritis?
Primary: No real cause why they occur.
Secondary: It has underlying Couse like Obesity, RA, Diabetes.
What is the Epidemiology of OA?
Age: 55 years or older and increase with age the OA increase.
Soccer or Rugby, hockey etc can lead to OA.
Genetics and lifestyle also could be a good cause for OA.
What are the risk factors for Osteo Arthritis?
Age Genetics Gender Injury Occupation Muscle weakness
Which Joints are mostly affected with Osteo Arthritis?
OA attacks fingers: Toes Thumb knee Hip Neck and low back
What are the specific joints suffer in Osteoarthritis?
Knee (Common in female) One or both
Hip (Both for male & female) One or both.
Hands mainly affects female. Bouchards nodes and Heberdens nodes.
OA in the neck and back called spondylosis but they are often asymptomatic.
OA in the foot each especially base of the big toe & interphalangeal joints
What is called Spondylosis?
OA in the neck and back
What would be the main findings of Osteo Arthritis?
Surface of knee joints damaged Cysts in the bone Bone grows thicker Further progression patient might experience damage of articular cartilage but also some other tissues Synovium (side er kurmuriata) Ligaments Neuromuscular tissue.
What are the important ARTICULAR changes in OA?
Early Stage: Cartilage is thinner than normal
Progression stage: Joint surface breached and fibrillation (fiber) developed.
Chondrocytes replicate and form clusters.
Late-stage: Cartilage becomes hypocellular (less than normal number of cells)
What are the important BONE changes in OA?
Bone remodelling and hypertrophy (means increase of cell size result muscle size)
Appositional bone growth in subchondral region leading to sclerosis(deformity).
Pathogenesis (way of development) of Osteo Arthritis?
The extracellular matrix of normal cartilage contains:
• Proteoglycans (PGs): responsible for compressive stiffness of the tissue and hold weight of body.
• Collagen: Provides tensile strength.
• MMPs responsible to degrade all extracellular matrix components.
• Primary changes occur in the cartilage.
• MMPs (Matrix metalloproteinases) have an important role for loss of cartilage in OA.
• Secretion of MMPs stimulate IL-1 factor (mechanical stimuli).
What ate the functions of PGs?
Withstand load
What ate the functions of Collagen?
Provide Tensile strength
What ate the functions of MMPs?
Degrade all Extracellular matrix components result cartilage loss. Secretion of MMPs also stimulate IL-1 factor
What are the symptoms of OA?
- Pain (become worse with activity and improve with rest)
- Stiffness usually inactivating last for less than 30 min
- Usually mild and swelling
- Sleep disturbance
- Fatigue (feeling of tiredness or lack of energy)
What are the SIGNS of Osteo Arthritis?
- Painful gait
- Osteophytes (Enlargement of bone)
- Crepitus (Noise)
- Ligamentous laxity (loose ligaments)
- Deformity
- Loss of mobility a joint motion
What are the Causes of joint pain in OA?
Synovium=> Inflammation Subchondral bone=> microfractures Ligaments=> stretching Joint capsule=> Inflammation Muscle=> spasm
How to Diagnose OA?
Based on symptoms and radiographic features.
Radiographic finding: Joint space narrowing.
Subchondral cysts
Osteophytosis
What are the available Lab tests we can for OA?
No specific lab test is available for diagnosing OA at this stage.
OA is not systemic so Lab tests ESR CBC Urine analysis will be normal.
Joint fluid might help to reveal mild leukocytosis (WBC increase in blood during infection)
What would be our treatment goal for OA?
Reduce pain
Improve function/minimise disability (loss weight & do physical exercise to improve muscle strength)
Improve quality of life.
What is the main difference between OA and RA?
OA
Stiffness in morning or Inactiveness and last less than 30 min.
Would be only localised pain but not systemic.
Pain worsens with activity.
Symmetry Occasional
Instability common
Not systemic
RA Usually in the morning and lasts more than 30 min. Would be systemic pain Pain worsen with prolong IN-Activity. About sign Symmetry common Tenderness over entire joint spaces. Instability not common. Systemic
What are the differences for Radiographic findings for RA and OA?
RA: Bone erosion Narrowing of Joints Osteopenia (lose bone mass and your bones get weaker) OA: Osteophytes Sclerosis Narrowing of joint space.
What are the differences between OA Vs RA?
Lab findings: RA: ESR, CRP, Rheumatoid Factor (RF)
OA: Not much
