Osteoarthritis

Question 1

Define osteoarthritis

Answer 1

Age related degenerative joint disease when cartilage destruction exceeds repair, causing pain & disability

Question 2

Aetiology of osteoarthritis

classification + 4

Answer 2

Can be classified according to distribution of affected joints

Synovial joint cartilage destruction
Eventually loss of joint volume due to altered chondrocyte activity
Patchy chronic synovial inflammation
Fibrotic thickening of joint capsules

Question 3

Aetiology of primary osteoarthritis

2

Answer 3

UNKNOWN aetiology

Multifactorial causes

Question 4

Aetiology of secondary osteoarthritis

5

Answer 4

Other diseases lead to altered joint architecture & stability

Commonly associated diseases:
developmental abnormalities (e.g. hip dysplasia)
trauma (e.g. previous fractures)
inflammatory (e.g. rheumatoid arthritis, gout, septic arthritis)
metabolic (e.g. haemochromatosis, acromegaly)

Question 5

Epidemiology of osteoarthritis

prevalence, age, gender/race

Answer 5

COMMON
25% of those > 60 yrs
More common in females, caucasians & asians

Question 6

Presenting symptoms of osteoarthritis

6

Answer 6

Joint pain & discomfort (use related)
Stiffness or gelling after inactivity
Difficulty w/ certain movements
Feelings of instability
Restriction walking, climbing stairs & doing manual tasks
Systemic features usually absent

Question 7

Signs of osteoarthritis on physical examination

7

Answer 7

Local joint tenderness
Bony swelling along joint margin
Heberden’s nodes - DISTAL interphalangeal joint
Bouchard’s nodes - PROXIMAL interphalangeal joint
Crepitus & pain during joint movement
Joint effusion
Restriction of range of joint movement

Question 8

Investigations for osteoarthritis

1 -4

Answer 8

Joint xray

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4 classic features
Loss of joint space (narrowing)
Osteophytes
Subchondral cysts
Subchondral sclerosis
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