Oestoarthritis Flashcards
What is osteoarthritis?
A degenerative joint disorder in which there is progressive loss of articular cartilage accompanied by new bone formation + capsular fibrosis
Risk factors for osteoarthritis
- increasing age
- female
- obesity
- trauma to joint
- occupation - jobs which cause significant wear and tear to specific joints
Aetiology of osteoarthritis
- failure of normal cartilage due to abnormal usage for long periods of time
- damaged or defective cartilage filing under normal loading
- break up of cartilage due to defective stiffened subchondral bone passing more load to it
Key features of cartilage in osteoarthritis
- loss of elasticity with reduced tensile strength
- cellularity + proteoglycans content reduced
Commonly affected joints in osteoarthritis
- DIPs in hand
- CMC in base of thumb
- C spine (cervical spondylosis)
- L spine
- hip
- knees
Presentation of osteoarthritis
- join pain + stiffness
- worsens with activity
- eases with rest
- reduced range of motion
- joint effusions
- Heberden’s nodes
- Bouchard’s nodes
Signs in the hands of OA
- heberden’s nodes in DIP
- bouchard’s nodes in PIP
- squaring of the thumb at CMC joint
- weak grip
- reduced ROM
X ray features of osteoarthritis
LOSS
- Loss of joint space
- Osteophytes
- Subarticular sclerosis
- Subchondal cysts
Diagnosis of osteoarthritis
Diagnosis can be made without investigations if patient is:
- over 45
- has typical pain associated with activity
- no morning stiffness (or <30mins)
Management of osteoarthritis
- weight loss
- occupational therapy
- therapeutic exercise to improve strength
. - regular paracetamol
- topical NSAIDs
- topical capsaicin
- intra-articular steroid injections
- joint replacement if severe
How does capsaicin work in treatment of osteoarthritis?
It is an active component of chilli peppers
It creates heat around the joint + helps to improve symptoms
