OA Flashcards
what cartilage in knee etc
hyaline
what nodes in the fingers in OA
bouchards at the pips
heberdens at the dips
menisci are what cartilage
fibro cartilage
where do you see OA in 20 year olds? what are they called
spinal column
syndesmophytes
what cells live in hyaline cartilage and how are they nourished
chondrocytes diffusion (hyaline carilage is avascular)
what is the line between the the articular cartilage and the calcified zome called?
tidemark
describe the layers of articular cartilage
how much % of articular cartilage is chondrocytes
5
deeper chondrocytes have a lot of
golgi and endoplasmic reticulum
what draws water in to hydrate art cartilage. how?
proteoglycans. high neg charge
what collagens art cart
2 at the top, 10 at the bottom
2 is most common
which layer of art cart is compressable>? how
middle, criss-cross collagen
which OA has the highest genetic link. how much
spinal 70%
what is the alternative name of COX2. what is the relevance to OA
PTGS2 - increased inflammation, oxidative stress
what comes first in OA? synovitis or cartilage/bone pathology
cart bone
what is the main cause of loss of funct in OA
synovitis
women are most sussceptible to knee OA becaus
Q angle is bigger
major factor in oa progression. which gene? what does it do
loss of superficial chondrocytes
HMGB2
loss of progenitor cells
reduced synthesis of ECM components
3 phases of OA
fibrillation
erosion
eburnation (complete loss of cartilage)
which condition would see duplication of the tidemark
OA
in OA what can happen to the collagen in the joint
change from 2 to 1
less compressable, rougher
what is this sign of OA
isogenic clusters
few chondrocytes nearby so cells cluster to compensate
what enzymes are released from stressed chondrocytes in OA
MMPs
collagenases
ADAMTs
what is softening of collagen called
chondromalacia
which specific MMP is linked with OA
MMP13
what is the conseauence of loss of proteoglycans in the superficial layer of art cart in OA
dehydration
3 bone consequences of OA
subchondral cysts
sclerotic (denser, woven) bone
vascular engorgement leading to bone marrow oedema
where do osteophytes grow? where do you see it? Why?
all over
only at joint margins
gets worn down at articular surfaces
example of COX-2 inh
celecoxib
what is thw trigger for writing an OA referral to surgery
waking at night from pain
3 pre-replacement surgical options for OA
washin and debridement
micro-fracture
chodrocyte grafting
women show more severe OA symptoms in which joints
hand and knee
premature polyarticular OA has a genetic component. the genes coding for what are broken
collagen 2
what are the big 3 co-morbidities
CV
OA
MH
pseudogout??
Perthe’s disease
grading of OA
Grade 0
Normal
Grade 1
Very minor bone spur no pain or discomfort
Grade 2
1st time people experience symptoms, pain on walking more bone spurs
Grade 3
Moderate OA with frequent pain and joint stiffness especially after rest, cartilage shows damage
Grade 4
Severe OA with dramatic loss of joint space high levels of pain and discomfort during walking or moving joint
what is pseudolaxity
loss of cartilage in eg knee causes loss of joint height so ligament becomes lax despite being normal length and tension
what is erosive OA and where
erosions in the dip and pip joints. very deforming
severe subset of nodal generalised OA.
can be confused with RA.
inflammatory
gullwing joint appearance on OA
erosive arthritis new tx
tnf inhibitor
where does OA start
in the cartilage
which IL causes morning stiffness in RA and OA
6
how long is mornin stiddness in RA/OA
> 60mins
<60 mins
