osteoarthiritis

Question 1

define osteoarthritis

Answer 1

A chronic, degenerative joint disease involving the breakdown and eventual loss of the articular cartilage in the joints.

Question 2

is osteoarthritis an inflammatory condition

Answer 2

NO

Question 3

risk factors for osteoarthritis

Answer 3

• age 50+
• women
• obesity
• occupation/sports
• genetic
• previous joint trauma

Question 4

how does genetics impact osteoarthritis

Answer 4

COL2A1 gene - genetic predisposition

Question 5

where does osteoarthritis occur

Answer 5

in the synovial joints

Question 6

what is osteoarthiritis the result of

Answer 6

It is thought to be the result of an imbalance between the cartilage being worn down and the chondrocytes repairing it leading to structural issues in the joint

Question 7

symptoms of osteoarthirits

Answer 7

• painful joints stiff for 30 minutes or less in the morning
• worse throughout the day (worsened by activity in contrast to inflammatory arthritis)
• deformity
• instability
• reduced function in the joint.

Question 8

3 causes of osteoarthirtis

Answer 8

1. Age-related degeneration of articular cartilage.
2. Mechanical stress on the joints due to obesity or injury.
3. Genetic predisposition.

Question 9

commonly affected joints in osteoarthirits

Answer 9

• Hips
• knees
• Sacro-Iliac Joints
• Distal-interphalangeal joints in the hands (DIPs)
• the CMC joint at the base of the thumb
• Wrist
• Cervical spine

Question 10

signs of osteoarthritis in the hands

Answer 10

• Heberden’s nodes(in the DIP joints)
• Bouchard’s nodes(in the PIP joints)
• Squaringat thebase of the thumb
• Weak grip
• Reduced range of motion.

Question 11

describe how joints appear in osteoarthritis

Answer 11

asymmetric, hard, non inflamed

Question 12

are there any extra-articular symptoms in osteoarthritis

Answer 12

no

Question 13

what is the main diagnostic investigation for osteoarthritis

Answer 13

X ray

Question 14

what does an osteoarthiritis x ray show

Answer 14

LOSS
1. loss of joint space
2. osteophytes
3. sclerosis
4. subchondral cysts

Question 15

what is sclerosis

Answer 15

increased density of the bone along the joint line

Question 16

what are subchondral cysts

Answer 16

fluid filled holes in the bone, aka geodes

Question 17

describe what a blood test for osteoarthritis would show

Answer 17

normal because no inflammation

Question 18

4 treatment options for osteoarthritis

Answer 18

1. lifestye changes
2. NSAID pain relief
3. intra articular steroid injections
4. surgery - last resort

Question 19

what lifestyle changes can you make for osteoarthiritis

Answer 19

• weight loss (reduce load on joint)
• physiotherapy (improve
  strength to support the joint),
• occupational therapy and orthotics to support activities and function)

Question 20

what medications do you use for osteoarthirits

Answer 20

• Paracetamol, topical NSAIDs or topical capsaicin
• Oral NSAIDS and PPI to protect stomach- better used intermittently
• Opiates e.g., codeine and morphine (don’t work for chronic pain and leads to addiction)

Question 21

what. do intra articular steroid injections do

Answer 21

provide temporary reduction in inflammation and improve symptoms

used for less than 10 weeks

Question 22

which joints is surgery recommended for

Answer 22

knee and hip replacement

arthroplasty

Question 23

pathophysiology of osteoarthritis

Answer 23

1. imbalanced cartilage breakdown > repair
2. increased chondrocyte metalloproteinase secretion
3. degrades t2 collagen
4. causes cysts
5. bone attempts to overcome this with t1 collagen
6. leads to abnormal bone growths (osteophytes) and remodelling

Question 24

why are lab tests done for osteoarthiritis

Answer 24

to rule out other forms of arthiritis