Osteoarthritis ☺️

Question 1

Epidemiology
Risk factors
Pathophysiology

Answer 1

Prevalence increases with age
Not a normal part of ageing but a consequence

High genetic correlation
Female esp after menopause
Obesity
Previous injury
Age

Wear and tear of joint

Question 2

Investigations

Answer 2

Used to exclude other differentials
-bloods => exclude inflammatory, infective causes

Imaging => confirm diagnosis, exclude fractures
Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis

Question 3

Clinical syndrome

Answer 3

Gradual onset pain over years
Heberdens - DIP
Bouchards - PIP

Exacerbated by activity, relieved by rest
Pain occurs less with activity, occurs at rest and night with progression

Question 4

Management

• conservative
• medical
• surgical

Answer 4

Conservative

• weight loss, dietary changes
• physical activity to strengthen joints
• ice/heat packs

Medical

• simple analgesia, topical NSAIDs, capsaicin
• intraarticular steroids

Joint replacement

• prolonged, established functional limitations, severe pain
• patient specific factors aren’t CIs