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Clin Med 4 > MSK II - General Principles of Osteoarthritis > Flashcards

MSK II - General Principles of Osteoarthritis Flashcards

1
Q

causes of arthritis?

A

DJD, rheumatoid, post-traumatic, post-infection

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2
Q

what are modifiable local risk factors for DJD/OA?

A

muscle strength

physical activity/occupation

joint injury

joint alignment (biggest one)

leg length inequality

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3
Q

what muscles are the quad femoris muscles?

A

vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris

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4
Q

quad femoris muscles do what action?

A

leg extension

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5
Q

quads femoris is what primary muscle of the lower limb?

A

primary antigravity muscle of the lower limb

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6
Q

what does quads femoris absorb?

A

limb loading

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7
Q

what does quads femoris provide?

A

dynamic joint stability

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8
Q

improvement in strength of quads femoris is associated with what for knee OA?

A

associated with reduced pain and improved function in pts with knee OA

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9
Q

what muscles should be strengthened for knee OA?

A

the quads femoris muscles

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10
Q

what activities and occupations increase risk of OA?

A

repetitive joint use

occupations requiring squatting/standing/kneeling - 2x risk of OA

increased manual dexterity - features of hand OA

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11
Q

what is one of the most important injuries associated with OA?

A

ACL rupture

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12
Q

when will OA changes been seen in people with joint injury?

A

within 10 years after initial injury

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13
Q

joint injury has risk of OA if accompanied by damage to what?

A
  • Articular cartilage
  • Subchondral bone
  • Collateral ligaments
  • Menisci -> seen in 70% of ACL injured tears
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14
Q

what is the HIGHEST modifiable local risk factor for DJD/OA?

A

joint alignment

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15
Q

what is one of the strongest predictors of knee OA progression?

A

knee malalignment

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16
Q

joint alignment is the strongest predictors of what?

A

OA progression

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17
Q

what is malalignment strongly associated with?

A

increased degradation of compartment under greatest compressive stress

18
Q

medial progression of knee OA 4x more likely in individuals with what?

A

with varus alignment

19
Q

what is the #1 modifiable systemic risk factor for OA?

A

obesity

20
Q

obesity is most important risk factor for OA where?

A

hip/knee OA

21
Q

for every ___ unit increase in BMI, there is a ___ increased risk of knee OA

A

for every 5 unit increase in BMI, there is a 35% increased risk of knee OA

22
Q

modifiable systemic risk factors for OA?

A

obesity (#1), diet, bone metabolism

23
Q

what is the #1 predictor of OA?

A

age

24
Q

non-modifiable systemic risk factors for OA?

A

age (#1), sex (female), genetics, ethnicity

25
Q

what gender has a higher prevalence and severity of OA?

A

female

26
Q

if post-menopausal, most likely to have greater x-ray changes where than men?

A

greater knee x-ray changes

27
Q

what is the first line tx for mild-moderate arthritis pain?

A

APAP and add topical analgesics PRN

28
Q

if APAP fails or there is inflammation, then what meds for tx?

A

NSAIDs, viscosupplementation

29
Q

first line tx for arthritis? dose?

A

APAP - 325-650 mg q5h on scheduled basis

30
Q

max dose of APAP/day if EtOH or liver disease?

A

2g/day

31
Q

when do you use NSAIDs for arthritis tx?

A

if APAP fails

32
Q

most common adr of NSAIDs?

A

GI complaints

33
Q

what is capsaicin? how long to work? used how often?

A

topical analgesic
-extract of hot peppers, beneficial when topically applied over joints

2 weeks to work

can use QID, but only BID necessary

34
Q

what meds have a minimal role in DJD?

A

narcotics

35
Q

when do you use narcotics in DJD?

A

short term use for exacerbations; post-op

36
Q

when do you NOT use narcotics?

A

Pre-op

37
Q

valgus braces do what for arthritis?

A

mediate pain by mechanically stabilizing joint and reducing muscle co-contractions and joint compression

38
Q

poor knee stability correlated with what?

A

decreased ADLs, quality of life

39
Q

what is an example of viscosupplementation? found where? function?

A

hyaluronic acid
-found in synovial fluid and cartilage

function: lubricant and shock absorber

has anti-inflammatory effect and antioxidant effect

40
Q

what is definite tx of arthritis?

A

surgery - arthroplasty or osteotomy

41
Q

risk factor modification for arthritis tx?

A

muscle strengthening

weight management

Clin Med 4 (11 decks)

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