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Musculoskeletal > Non-Inflammatory Arthritis > Flashcards

Non-Inflammatory Arthritis Flashcards

1
Q

What is osteoarthritis?

A

articular cartilage failure causing thinning/loss of cartilage leading to loss of joint space

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2
Q

what subchondral features can occur in osteoarthritis?

A

subchondral sclerosis

subchondral cyst formation

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3
Q

what imbalance occurs in osteoarthritis?

A

decreased extra cellular matrix synthesis and increased protease activity
leading to thinning of cartilage

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4
Q

what type of collagen is predominant in cartilage?

A

type 2 collagen

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5
Q

what is the name for the extra growth of bones on the side of the head of the bones? (Caused by osteoarthritis)

A

osteophytes

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6
Q

why do subchondral cysts form in osteoarthritis?

A

synovial fluid gets into the bone

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7
Q

what are the 2 main types of osteoarthritis?

A

idiopathic

secondary

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8
Q

what are the 2 main types of idiopathic osteoarthritis?

A

localised

generalised

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9
Q

how many sites are involved in generalised osteoarthritis?

A

3 or more

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10
Q

what are the 7 main risk factors of osteoarthritis?

A
  1. age
  2. female sex
  3. obesity
  4. occpation
  5. sporting activities
  6. previous injury
  7. muscle weakness
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11
Q

how can muscle weakness lead to osteoarthritis?

A

muscle weakness can cause changes in the alignment of the joint
–>
this causes damage to the joint

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12
Q

what are the main symptoms of osteoarthritis?

A

pain and stiffness (esp morning)

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13
Q

how long does osteoarthritis morning stiffness usually last?

A

less than 30 mins

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14
Q

what are the 2 signs you may find on examination of a patient with suspected osteoarthritis? (not late stage)

A 
crepitus (due to bone rubbing on bone)
bony swelling (due to osteophytes)
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15
Q

what type of joints typically get osteoarthritis?

A

weight bearing joints with lots of movement

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16
Q

why do you rarely get osteoarthritis on thoracic spine?

A

little movement

17
Q

where in the upper arm does osteoarthritis tend to mainly affect?

A

hands

not much in elbows of shoulder

18
Q

what is the clinical sign of osteophyte formation at the distal interphalangeal joints?

A

Heberdens nodes

19
Q

what is the clinical sign of osteophyte formation at the proximal interphalangeal joints?

A

Bouchards nodes

20
Q

in genu varus, is the knee moving towards or away from the midline?

A

away from the midline

21
Q

in genu valgus, is the knee moving towards or away from the midline?

A

towards the midline

22
Q

what joints are mainly affected with osteoarthritis in the spine?

A

facet joints

23
Q

what is spinal claudication?

A

when patients find it hard to walk because the nerves of the spine are compressed (by osteophytes)

24
Q

what are the 4 main features of osteoarthritis seen on an X-ray?

A
  1. loss of joint space (because of lack of cartilage)
  2. subchondral sclerosis
  3. subchondral cysts
  4. osteophytes
25
Q

compare the primary joints affected of osteoarthritis to rheumatoid arthritis?

A

OA- distal interphalangeal and carpometacarpal

RA- proximal interphalangeal and metacarpophalangeal

26
Q

compare the joint swellings of osteoarthritis to rheumatoid arthritis?

A

OA- hard and bony swelling

RA- soft, warm and tender swelling

27
Q

compare the exacerbation/relievation of stiffness in osteoarthritis to rheumatoid arthritis?

A

OA- worse after effot

RA- worse after resting

28
Q

compare osteoarthritis to rheumatoid arthritis in terms of RF, anti-CCP and CRP?

A

OA- RF neg, anti-CCP neg, normal CRP

RA- RF pos, anti-CCP pos, elevated CRP

29
Q

what are the non-pharmacological management options of osteoarthritis?

A 
explanation
physiotherapy
weight loss
exercise
walking stick
30
Q

what are the pharmacological management options of osteoarthritis?

A
  • non-opiod analgesic (paracetamol, NSAIDs)
  • adjuvants (amitriptyline, gabapentin)
  • intra-articular steroids
  • intra-articular hyaluronic acid
31
Q

what are the surgical management options of osteoarthritis?

A
  • ideallly joint replacement

- arthroscopic washout + soft tissue trimming (eg for osteophytes)

32
Q

compare rheumatoid arthritis and osteoarthritis in terms of what happens with exercise?

A

osteoarthritis- gets worse with exercise
rheumatoid- gets better with exercise

[mechanical gets worse, inflammatory improves]

33
Q

what joints tend to be affected in psoriatic arthritis? (distrubition and location)

A

asymmetrical large joints

34
Q

which is more likely to affect the elbow- OA or RA?

A

RA

35
Q

OA of the elbow is rare, when might this occur?

A

secondary to trauma

36
Q 
are you likely to get OA in:
DIP joints
PIPs joints
MCPs joints
carpal-metacarpal joints
radio-metacarpal joints
A 
DIP- common
PIP- common (DIP > PIP)
MCPs- rare
carpal-metacarpal joints- common 
radio- metacarpal joints- rare

Musculoskeletal (16 decks)

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