Non-Inflammatory Arthritis Flashcards
What is osteoarthritis?
articular cartilage failure causing thinning/loss of cartilage leading to loss of joint space
what subchondral features can occur in osteoarthritis?
subchondral sclerosis
subchondral cyst formation
what imbalance occurs in osteoarthritis?
decreased extra cellular matrix synthesis and increased protease activity
leading to thinning of cartilage
what type of collagen is predominant in cartilage?
type 2 collagen
what is the name for the extra growth of bones on the side of the head of the bones? (Caused by osteoarthritis)
osteophytes
why do subchondral cysts form in osteoarthritis?
synovial fluid gets into the bone
what are the 2 main types of osteoarthritis?
idiopathic
secondary
what are the 2 main types of idiopathic osteoarthritis?
localised
generalised
how many sites are involved in generalised osteoarthritis?
3 or more
what are the 7 main risk factors of osteoarthritis?
- age
- female sex
- obesity
- occpation
- sporting activities
- previous injury
- muscle weakness
how can muscle weakness lead to osteoarthritis?
muscle weakness can cause changes in the alignment of the joint
–>
this causes damage to the joint
what are the main symptoms of osteoarthritis?
pain and stiffness (esp morning)
how long does osteoarthritis morning stiffness usually last?
less than 30 mins
what are the 2 signs you may find on examination of a patient with suspected osteoarthritis? (not late stage)
crepitus (due to bone rubbing on bone) bony swelling (due to osteophytes)
what type of joints typically get osteoarthritis?
weight bearing joints with lots of movement
why do you rarely get osteoarthritis on thoracic spine?
little movement
where in the upper arm does osteoarthritis tend to mainly affect?
hands
not much in elbows of shoulder
what is the clinical sign of osteophyte formation at the distal interphalangeal joints?
Heberdens nodes
what is the clinical sign of osteophyte formation at the proximal interphalangeal joints?
Bouchards nodes
in genu varus, is the knee moving towards or away from the midline?
away from the midline
in genu valgus, is the knee moving towards or away from the midline?
towards the midline
what joints are mainly affected with osteoarthritis in the spine?
facet joints
what is spinal claudication?
when patients find it hard to walk because the nerves of the spine are compressed (by osteophytes)
what are the 4 main features of osteoarthritis seen on an X-ray?
- loss of joint space (because of lack of cartilage)
- subchondral sclerosis
- subchondral cysts
- osteophytes
compare the primary joints affected of osteoarthritis to rheumatoid arthritis?
OA- distal interphalangeal and carpometacarpal
RA- proximal interphalangeal and metacarpophalangeal
compare the joint swellings of osteoarthritis to rheumatoid arthritis?
OA- hard and bony swelling
RA- soft, warm and tender swelling
compare the exacerbation/relievation of stiffness in osteoarthritis to rheumatoid arthritis?
OA- worse after effot
RA- worse after resting
compare osteoarthritis to rheumatoid arthritis in terms of RF, anti-CCP and CRP?
OA- RF neg, anti-CCP neg, normal CRP
RA- RF pos, anti-CCP pos, elevated CRP
what are the non-pharmacological management options of osteoarthritis?
explanation physiotherapy weight loss exercise walking stick
what are the pharmacological management options of osteoarthritis?
- non-opiod analgesic (paracetamol, NSAIDs)
- adjuvants (amitriptyline, gabapentin)
- intra-articular steroids
- intra-articular hyaluronic acid
what are the surgical management options of osteoarthritis?
- ideallly joint replacement
- arthroscopic washout + soft tissue trimming (eg for osteophytes)
compare rheumatoid arthritis and osteoarthritis in terms of what happens with exercise?
osteoarthritis- gets worse with exercise
rheumatoid- gets better with exercise
[mechanical gets worse, inflammatory improves]
what joints tend to be affected in psoriatic arthritis? (distrubition and location)
asymmetrical large joints
which is more likely to affect the elbow- OA or RA?
RA
OA of the elbow is rare, when might this occur?
secondary to trauma
are you likely to get OA in: DIP joints PIPs joints MCPs joints carpal-metacarpal joints radio-metacarpal joints
DIP- common PIP- common (DIP > PIP) MCPs- rare carpal-metacarpal joints- common radio- metacarpal joints- rare
