Osteoartgritis

Question 1

Where are herbedens nodes in osteoarthritis?

Answer 1

Distal interpharyngral joints

Question 2

What nodes are found at the PIPs in osteoarthritis?

Answer 2

Bouchards nodes

Question 3

What joints are often affected in hands in osteoarthritis?

Answer 3

DIPS (Herbedens), Bouchards (PIPs), CMC = base of thumb

Question 4

What is another common cause of CMC joint problem?

Answer 4

Gout

Question 5

What gait is only seen in severe osteoarthritis of the hip

Answer 5

Trendelenburg

Question 6

Risk factors for osteoarthritis

Answer 6

Genetic - ligament laxity, joint misalignment
Demographic - older, female
Mechanism - injury, ligament problems. Inter articular fractures

Question 7

Where is movement restricted in hip osteoarthritis

Answer 7

Internal rotation when hip flexed

Question 8

Where is pain in hip osteoarthritis?

Answer 8

Deep anterior groin pain

Question 9

What can happen with knee osteoarthritis?

Answer 9

Giving way
Locking
Decreased flexion and extension

Question 10

First line for osteoarthritis

Answer 10

NSAIDS - local

Question 11

Referrals for osteoarthritis

Answer 11

PT, OT
Podiatrist
Orthopaedics

Question 12

When does OA occur?

Answer 12

Imbalance between joint breakdown and sufficient repair process

Question 13

What is found in the cartliage of joints in people with OA?

Answer 13

IL-1,, TNF alpha, protease enzymes -> cartliage damage

Question 14

Non pbarmacological management OA

Answer 14

Exercise
Education and advice
Weight loss
Physiotherapy
TENS
Aids and devices

Question 15

Medications used in OA

Answer 15

Simple analgesia for symptom relief - paracetemol
Topical capsacin
NSAIDs - topical or ora (+PPI)
Weak opioid eg codeine
Intra-articular corticosteroid injections

Question 16

What is seen on X ray on OA?

Answer 16

LOSS
Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis

Question 17

Investgiations for RA

Answer 17

PlainX ray
Bloods
MRI
Arthroscopy
Joint aspiration

Question 18

Risk factors for OA

Answer 18

Age
Gender
FH
Bone density
Obesity
Injury
Joint damage
Joint site
Occupation

Question 19

Signs of OA

Answer 19

Periarticular tenderness
Crepitus
Decreased range of movement
Muscle wasting
Swelling of PIPs + DIPs - bouchards and herbedens
effusion
Squaring thumb

Question 20

Symptoms of OA

Answer 20

Joint pain - worse when move, load bear, end of day
Joint stiffness - less than 30 mins
Reduced function
Instability

Question 21

When can you diagnose OA without inveztiaiton

Answer 21

Over 45 yrs old

Question 22

Where are bouchards nodes

Answer 22

PIPs

Question 23

Where are herbedens nodes

Answer 23

DIPs - outer Hebrides