Oestoarthritis

Question 1

Aetiology and risk factors of Oestoarthritis

Answer 1

Thought as wear and tear-but more complex
cartilage degeneration/degradation-fibrillation
With new bone formation (oestophytes)
Inflammation (synovitis)

risk factors:
Older people
Obesity
Work strain

Question 2

signs and sx of Oestoarthritis

Answer 2

Slow onset over a while in older people
Pain on weight baring,
No stiffness
Worse as you use it
Small joints of the hand, or large joints like hips and knees-but not many joints

Swelling is possible

Crepitus on movement

DIP-heberdens nodes
PIP-bouchards nodes
Squaring of thumb base
Varus/valgus at knee (if medial-varus (inwards), etc)

Hx for general MSK-other autoimmune disease?
Whats their work?
Joint swelling?

Question 3

Investigations of Oestoarthritis

Answer 3

Xray–Loss of joint space, subchondral sclerosis (white thicken),
cysts and
osteophytes-
thats the 4 classic ones

Question 4

Management of Oestoarthritis

Answer 4

No disease modifying drug
Education - self care -weight loss and exercise

Pain medication-paracetamol, can even go to opioids (avoid NSAIDs)
1st line Paracetamol and Topical NSAIDS
2nd line - Oral NSAIDS / Opioids
Topical capsaisin
physiotherapy

refer–
Steroid injections
Surgery