osteoarthiritis Flashcards
define osteoarthritis
A chronic, degenerative joint disease involving the breakdown and eventual loss of the articular cartilage in the joints.
is osteoarthritis an inflammatory condition
NO
risk factors for osteoarthritis
- age 50+
- women
- obesity
- occupation/sports
- genetic
- previous joint trauma
how does genetics impact osteoarthritis
COL2A1 gene - genetic predisposition
where does osteoarthritis occur
in the synovial joints
what is osteoarthiritis the result of
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
symptoms of osteoarthirits
- 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.
3 causes of osteoarthirtis
- Age-related degeneration of articular cartilage.
- Mechanical stress on the joints due to obesity or injury.
- Genetic predisposition.
commonly affected joints in osteoarthirits
- Hips
- knees
- Sacro-Iliac Joints
- Distal-interphalangeal joints in the hands (DIPs)
- the CMC joint at the base of the thumb
- Wrist
- Cervical spine
signs of osteoarthritis in the hands
- 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.
describe how joints appear in osteoarthritis
asymmetric, hard, non inflamed
are there any extra-articular symptoms in osteoarthritis
no
what is the main diagnostic investigation for osteoarthritis
X ray
what does an osteoarthiritis x ray show
LOSS
1. loss of joint space
2. osteophytes
3. sclerosis
4. subchondral cysts
what is sclerosis
increased density of the bone along the joint line
what are subchondral cysts
fluid filled holes in the bone, aka geodes
describe what a blood test for osteoarthritis would show
normal because no inflammation
4 treatment options for osteoarthritis
- lifestye changes
- NSAID pain relief
- intra articular steroid injections
- surgery - last resort
what lifestyle changes can you make for osteoarthiritis
- weight loss (reduce load on joint)
- physiotherapy (improve
strength to support the joint), - occupational therapy and orthotics to support activities and function)
what medications do you use for osteoarthirits
- 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)
what. do intra articular steroid injections do
provide temporary reduction in inflammation and improve symptoms
used for less than 10 weeks
which joints is surgery recommended for
knee and hip replacement
arthroplasty
pathophysiology of osteoarthritis
- imbalanced cartilage breakdown > repair
- increased chondrocyte metalloproteinase secretion
- degrades t2 collagen
- causes cysts
- bone attempts to overcome this with t1 collagen
- leads to abnormal bone growths (osteophytes) and remodelling
why are lab tests done for osteoarthiritis
to rule out other forms of arthiritis
