OA Flashcards
What is osteoarthritis often described as?
“Wear and tear” in the joints.
Where does osteoarthritis occur?
In the synovial joints.
What are the main factors that contribute to osteoarthritis?
- Genetic factors
- Overuse
- Injury
What is thought to cause osteoarthritis?
An imbalance between cartilage damage and the chondrocyte response, leading to structural issues in the joint.
List the risk factors for osteoarthritis.
- Obesity
- Age
- Occupation
- Trauma
- Being female
- Family history
Which joints are commonly affected by osteoarthritis?
- Hips
- Knees
- Distal interphalangeal (DIP) joints in the hands
- Carpometacarpal (CMC) joint at the base of the thumb
- Lumbar spine
- Cervical spine (cervical spondylosis)
What is the ‘LOSS’ mnemonic for X-ray changes in osteoarthritis?
- L – Loss of joint space
- O – Osteophytes (bone spurs)
- S – Subarticular sclerosis (increased bone density)
- S – Subchondral cysts (fluid-filled holes in the bone)
Do X-ray changes correlate directly with osteoarthritis symptoms?
No, they may not correlate.
How does osteoarthritis pain and stiffness present?
Pain and stiffness worsen with activity and at the end of the day.
What are the general signs of osteoarthritis?
- Bulky, bony enlargement
- Restricted range of motion
- Crepitus on movement
- Effusions (fluid) around the joint
What are the signs of osteoarthritis in the hands?
- Heberden’s nodes (DIP joints)
- Bouchard’s nodes (PIP joints)
- Squaring at the base of the thumb (CMC joint)
- Weak grip
- Reduced range of motion
Why is the carpometacarpal joint at the base of the thumb prone to osteoarthritis?
It is a saddle joint and gets a lot of use.
What is a TOM TIP regarding osteoarthritis?
Consider referred pain, especially in adjacent joints.
What does the NICE 2022 guideline suggest for diagnosing osteoarthritis?
A diagnosis can be made without investigations if the patient is over 45, has typical pain associated with activity, and no morning stiffness (or stiffness lasting under 30 minutes).
What are some non-pharmacological management strategies for osteoarthritis?
- Therapeutic exercise
- Weight loss
- Occupational therapy
What is the first-line pharmacological treatment for knee osteoarthritis?
Topical NSAIDs.
When are weak opiates and paracetamol recommended for osteoarthritis?
Only for short-term, infrequent use.
What might be used in severe cases of osteoarthritis?
Joint replacement, particularly of the hips and knees.
What are the potential adverse effects of NSAIDs?
- Gastrointestinal side effects (gastritis, ulcers)
- Renal side effects (acute kidney injury)
- Cardiovascular side effects (hypertension, MI, stroke)
- Exacerbating asthma
Why should NSAIDs be used cautiously in older patients and those on anticoagulants?
Due to their potential adverse effects, including gastrointestinal and renal issues.
What is a TOM TIP regarding the WHO pain ladder in osteoarthritis?
The WHO pain ladder is not helpful in chronic pain.
What do NSAIDs cause that may be dangerous for patients with high blood pressure?
NSAIDs block prostaglandins, which cause vasodilation, leading to hypertension.
