Osteoarthritis

Question 1

What are the 3 aetiologies for OA?

Answer 1

• Failure of normal cartilage due to abnormal or inappropriate load
• Damaged or defective cartilage failing under normal conditions of loading
• Break up of cartilage due to defective stiffened subchondral bone passing more load to it

Question 2

What are the 2 key features of the cartilage in OA?

Answer 2

• loss of elasticity with reduced tensile strength

* cellularity and proteoglycan content reduced

Question 3

What are the risk factors for OA?

Answer 3

• Increasing age
• Female gender
• Obesity - incidence and progression at hand and knee
• Trauma and joint malalignment or muscle weakness
• Genetics (knee and hand)

Question 4

What are the signs and symptoms of OA?

Answer 4

Pain made worse by movement and weight bearing

Initially intermittent pain that may become constant

Feeling of giving way at knee joint if knee affected

Question 5

What joints are commonly affected in OA?

Answer 5

Hip
Knee
Spine

Question 6

What are the x-ray features of OA?

Answer 6

LOSS
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral bone cysts

Question 7

What are the non-drug treatments for OA?

Answer 7

• PT - strengthening and range of movement exercises
• Weight loss
• Laterally wedges insoles/walking stick

Question 8

What is the pharmacological treatment for OA?

Answer 8

• Paracetemol (regular)
• NSAIDs acutely (topical are useful)
• Intra-articular corticosteroids

Question 9

When is surgery considered with OA?

Answer 9

When pharmacological and physical treatments are insufficient

Question 10

What is nodal OA?

Answer 10

Affects PIPJs (Bouchard’s nodes) and DIPJs (Heberden’s nodes) and thumb CMCJ

More common in women and strongly associated with development and progression of knee OA