Non-inflammatory Arthritides: Osteoarthritis

Question 1

Osteoarthritis
-risk factors

Answer 1

Older females
Wear and tear from
-past trauma
-obesity
-occupational
Osteoporosis

Question 2

Presentation of osteoarthritis in
-hands
-hips

Answer 2

Bilateral - CMC, DIPs
Heberdens - DIPs
Bouchards - PIPs
Squaring of thumbs

Groin hip pain

Pain worse on use, better when rested
Stiffness lasts for mins

Question 3

Osteoarthritis
-diagnosis

Answer 3

Xray
-Loss of joint space
-Osteophytes
-Subchondral cysts
-Subchondral sclerosis

Often radiological signs develop before symptoms

Question 4

Osteoarthritis
-management

Answer 4

Lifestyle
-weight loss
-muscle strengthening, aerobic fitness

Analgesia
1st line if symptomatic - TOP NSAIDs + PPI
-ibuprofen gel
-alt capsaicin
2nd line if TOP not enough or CI - PO NSAIDs + PPI
3rd line - CS injections if moderate/severe

Joint replacement surgery if persistent severe pain, significant functional limitations, conservative failure
-followed by physio and home exercise
-walking stick/crutches to support recovery

Question 5

Minimising risk of dislocation after HR
Complications

Answer 5

Avoid flexing hip 90deg+
Avoid low chairs
Don’t cross legs
Don’t sleep on back for 1st 6wks

Wound, joint infection
Thromboembolism - use LWMH 4wks post surgery
Dislocation