MSK 01

Question 1

What is (OA) Osteoarthritis?

Answer 1

Also known as degenerative joint disease.
Osteo means bone & Arthritis means inflammation of joint.
Chronic joint disease leads to immobility & destruction of joints

Question 2

What are the types of (OA) Osteoarthritis?

Answer 2

Primary: No real cause why they occur.
Secondary: It has underlying Couse like Obesity, RA, Diabetes.

Question 3

What is the Epidemiology of OA?

Answer 3

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.

Question 4

What are the risk factors for Osteo Arthritis?

Answer 4

Age 
Genetics
Gender
Injury
Occupation 
Muscle weakness

Question 5

Which Joints are mostly affected with Osteo Arthritis?

Answer 5

OA attacks fingers: 
Toes 
Thumb 
knee 
Hip 
Neck and 
low back

Question 6

What are the specific joints suffer in Osteoarthritis?

Answer 6

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

Question 7

What is called Spondylosis?

Answer 7

OA in the neck and back

Question 8

What would be the main findings of Osteo Arthritis?

Answer 8

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.

Question 9

What are the important ARTICULAR changes in OA?

Answer 9

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)

Question 10

What are the important BONE changes in OA?

Answer 10

Bone remodelling and hypertrophy (means increase of cell size result muscle size)
Appositional bone growth in subchondral region leading to sclerosis(deformity).

Question 11

Pathogenesis (way of development) of Osteo Arthritis?

Answer 11

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).

Question 12

What ate the functions of PGs?

Answer 12

Withstand load

Question 13

What ate the functions of Collagen?

Answer 13

Provide Tensile strength

Question 14

What ate the functions of MMPs?

Answer 14

Degrade all Extracellular matrix components result cartilage loss. Secretion of MMPs also stimulate IL-1 factor

Question 15

What are the symptoms of OA?

Answer 15

• 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)

Question 16

What are the SIGNS of Osteo Arthritis?

Answer 16

• Painful gait
• Osteophytes (Enlargement of bone)
• Crepitus (Noise)
• Ligamentous laxity (loose ligaments)
• Deformity
• Loss of mobility a joint motion

Question 17

What are the Causes of joint pain in OA?

Answer 17

Synovium=> Inflammation
Subchondral bone=> microfractures
Ligaments=> stretching 
Joint capsule=> Inflammation
Muscle=> spasm

Question 18

How to Diagnose OA?

Answer 18

Based on symptoms and radiographic features.
Radiographic finding: Joint space narrowing.
Subchondral cysts
Osteophytosis

Question 19

What are the available Lab tests we can for OA?

Answer 19

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)

Question 20

What would be our treatment goal for OA?

Answer 20

Reduce pain
Improve function/minimise disability (loss weight & do physical exercise to improve muscle strength)
Improve quality of life.

Question 21

What is the main difference between OA and RA?

Answer 21

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

Question 22

What are the differences for Radiographic findings for RA and OA?

Answer 22

RA: Bone erosion
Narrowing of Joints
Osteopenia (lose bone mass and your bones get weaker)
OA:
Osteophytes 
Sclerosis
Narrowing of joint space.

Question 23

What are the differences between OA Vs RA?

Answer 23

Lab findings: RA: ESR, CRP, Rheumatoid Factor (RF)

OA: Not much