Osteoarthritis Flashcards
1
Q
RF of OA
A
- Risk factors: obesity, age, occupation, trauma, female and FHx.
2
Q
Briefly explain the pathophysiology of OA
A
- Thought to be an imbalance between cartilage being worn down and chondrocytes repairing it leading to structural issues in the joint.
3
Q
What changes would you see on X-ray in OA?
Hint: (LOSS)
A
- Loss of joint space
- Osteophytes
- Subarticular sclerosis (increased bone density at joint line)
- Subchondral cysts (fluid filled holes in the bone)
4
Q
how does OA present?
A
- Joint pain and stiffness
- Pain worsens with activity in comparison to inflammatory arthritis.
- Leads to deformity, instability and reduced function in joint.
5
Q
which joints are affected in OA?
A
- Hips
- Knees
- Sacro-iliac joints
- DIPs
- MCP joint at the base of the thumb
- Wrist
- Cervical spine
6
Q
what signs are in the hands for OA?
A
- Haberdens nodes (in the DIPs)
- Bouchards nodes (in the PIPs)
- Squaring at the base of the thumb at the carpo-metacarpal joint.
- Weak grip
- Reduced range of motion
7
Q
how do you diagnose OA?
A
- NICE states that you can make a diagnosis without any investigations if the patient is >45, has typical activity related pain and has no morning stiffness lasting <30 mins.
8
Q
how do you manage OA?
A
- Patient education
- Weight loss
- Physiotherapy
- Occupational therapy
- Orthotics
9
Q
what analgesia could you use for OA symptoms?
A
- Paracetamol
- Topical NSAIDs
- Topical capsaicin
- Oral NSAIDs (but must be prescribed with PPI)
- Opiates such as codeine and morphine
- Intra-articular steroid injections
- Joint replacement in severe cases
