OA - Ix, Mx

Question 1

In OA, wear and tear leads to ? and ? of joint cartilage, leading to ? of the joint space.
There is associated inflammation, with ? of the joint capsule and
synovium, and eventually capsular ?.
The loss of ? is progressive, leading to eburnation (constant ?
of two naked bone surfaces rubbing together).

Answer 1

splitting
erosion
narrowing
thickening
fibrosis
cartilage
friction

Question 2

Small ? develop beneath this abnormal bone surface, and ? form as irregular outgrowths of the peripheral ? cartilage.
As the joint becomes less ? and less used, there may be secondary ? of the associated muscles

Answer 2

cysts
osteophytes
unstressed
mobile
atrophy

Question 3

On XR, there are thus four cardinal changes;
?
?
?
?

Answer 3

j space narrows
osteophytes
sclerosis
cystic formation

Question 4

Investigations;
Bloods: ???/???, ?? & ??? to rule out other pathologies.
XR: ? views to confirm presence of OA.
?/? if XR does not correlate with clinical picture

Answer 4

crp//esr, rf+ana
two
ct/mri

Question 5

Management;
It is important to remember to treat the ?/? rather than
? appearance.
Early OA is managed ?;

Answer 5

disability
symptoms
radiological
conservatively

Question 6

Early OA is managed conservatively;
o Patient ?.
o ? loss.
o Physiotherapy: ?/?/? of movement exercises.
o Reduction of ? factors: ? footwear, ? aids.
o ? for ankles/ wrists.
o ? ? of the knee: weight re-distribution.

Answer 6

ed
wt
strength
stability
range
mechanical
cushioned
walking
splints
offset bracing

Question 7

Pain relieving medications;
• ? and topical ? first line analgesia.
• Oral NSAIDs (+?) and topical ? second line.

Intra-? ?-guided corticosteroid injections;
• Provide ? term (variable, commonly under ?) relief if there is a painful joint ?.

Answer 7

paracetamol
nsaids
ppi
capsaicin
articular
xr
short
6w
effusion

Question 8

More severe symptoms leading to loss of ? are managed surgically;

o Total replacement arthroplasty;
• Common in the ?/?
• Delayed for longer in the ? due to poorer outcomes.

o ? compartment arthroplasty;
• Can occur in the knee if just ? side of the articular surface is diseased.

Answer 8

fx
knee
hip
knee
one
one

Question 9

More severe symptoms leading to loss of ? are managed surgically;

o Young patients may benefit from ? and joint ?, to
delay definitive management for months/ years.
• Must be clear history of ? ?.

o ? can be used in the ankle, spine or hand.
o ? osteotomies are also sometimes performed (?/?).

Answer 9

fx
arthroscopy
washout
mechanical locking

arthrodesis
realignment
knee/hip