OA/RA/Septic Joint

Question 1

What is OA?

Answer 1

degenerative disorder arising from the biochemical breakdown of articular (hyaline) cartilage in the synovial joints.

Question 2

How is OA diagnosed?

Answer 2

Osteoarthritis is typically diagnosed on the basis of clinical and radiographic evidence. [3, 4, 5, 6, 7] No specific laboratory abnormalities are associated with osteoarthritis.

Question 3

Non-phama treatments of OA include?

Answer 3

Patient education

Heat and cold

Weight loss [10]

Exercise

Physical therapy

Occupational therapy

Unloading in certain joints (eg, knee and hip)

Question 4

What is the difference between secondary OA and primary OA?

Answer 4

Secondary osteoarthritis is conceptually easier to understand: It refers to disease of the synovial joints that results from some predisposing condition that has adversely altered the joint tissues (eg, trauma to articular cartilage or subchondral bone). Secondary osteoarthritis can occur in relatively young individuals (see Etiology). [12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]

The definition of primary osteoarthritis is more nebulous. Although this form of osteoarthritis is related to the aging process and typically occurs in older individuals, it is, in the broadest sense of the term, an idiopathic phenomenon, occurring in previously intact joints and having no apparent initiating factor.

Question 5

Is OA inflammatory or noninflammatory in process?

Answer 5

Although osteoarthritis has been classified as a noninflammatory arthritis, increasing evidence has shown that inflammation occurs as cytokines and metalloproteinases are released into the joint.

Question 6

what is the first process that occurs in OA?

Answer 6

in early osteoarthritis, swelling of the cartilage usually occurs, because of the increased synthesis of proteoglycans; this reflects an effort by the chondrocytes to repair cartilage damage. This stage may last for years or decades and is characterized by hypertrophic repair of the articular cartilage.

Question 7

How does the cartilage eventually soften in OA leading to damage? (beyond just swelling, what is happening?)

Answer 7

proteoglycans are lost which is WHY it gets soft

Question 8

what compartment of the knee is most commonly affected by OA?

Answer 8

medial femorotibial compartment

Question 9

What sex is more commonly affected by OA?

Answer 9

in individuals older than 55 years, the prevalence of osteoarthritis is higher among women than among men.

Question 10

What race is more commonly affected by OA?

Answer 10

Native Americans

Question 11

Prognosis of joint replacement?

Answer 11

Super successful prognosis, with success rates for hip and knee arthroplasty generally exceeding 90%.

Question 12

What are the most common organisms to infect a joint?

Answer 12

Overall, although Neisseria gonorrhoeae remains the most common pathogen (75% of cases) among younger sexually active individuals, [7, 8] Staphylococcus aureus infection is the cause of the vast majority of cases of acute bacterial arthritis in adults and in children older than 2 years.

Question 13

For a sternoclavicular or Si joint infection what should you be thinking?

Answer 13

infection of the sternoclavicular and sacroiliac joints with Pseudomonas aeruginosa or Serratia species occurs almost exclusively in persons who abuse intravenous drugs.

Question 14

What joints are at most risk of becoming infected?

Answer 14

Previously damaged joints, especially those damaged by rheumatoid arthritis, are the most susceptible to infection.