osteoarthritis Flashcards
what is osteoarthritis ?
loss of cartilage at the end of the joints and associated changes at the bone ends and joint margins
which joints of the hand are most affected by osteoarthritis ?
DIP
1st carpometacarpal ( base of the thumb)
what is the pathophysiology of OA ?
ulceration and loss of articular cartilage
sclerosis of subchondral bone
osteophytes
subchondral cysts
what is the main type of collagen in articular cartilage ?
collagen type II
what are the features of primary osteoarthritis ?
happens with no underlying cause
incidence increases with age
typical joint distribution
what are the features of secondary osteoarthritis ?
develops secondary to underlying cause
can occur in young ages
atypical site affection
what are the symptoms and signs of OA ?
pain
stiffness
a grating or grinding sensation
soft or hard swelling
what is the difference in duration between inflammatory and degenerative ?
inflammatory - prolonged
degenerative - less than 30 mins and decreases with movement but remains painful
what is the difference in swelling between OA and RA ?
RA - soft swelling
OA - hard swellings
what is the condition of the joint space in OA ?
loss of joint space
what is the core treatment for osteoarthritis ?
exercise ( local muscle strengthening and general aerobic fitness )
when should the patient be referred for arthroscopic lavage ?
only when there is mechanical locking
what should be prescribed for the pain ?
topical NSAIDs first then move on to oral
what should be prescribed alongside the pain medications ?
PPI
when should joint replacement surgery be considered for these patients ?
only if there is substantial impact on the quality of life
