Osteoarthritis

Question 1

Patient with unilateral pain in right groin and right knee. Where is the most likely site of OA?

Answer 1

right hip

Question 2

Name four XR findings in OA

Answer 2

loss of joint space
osteophytes
subchondral sclerosis
subchondral cysts

Question 3

What is the management of OA?

Answer 3

conservative- PT, OT, weight loss, stop smoking, analgesia

Question 4

Patient with right hip OA reports pain now wakes her at night and you notice a 5 degrees fixed flexion deformity. What procedure would now be indicated?

Answer 4

right hip hemiarthroplasty

Question 5

List two short term and one long term complications of hip hemiarthroplasty

Answer 5

short term- delirium, infection

long term- reduced mobility

Question 6

Define OA

Answer 6

Degenerative joint disorder in which there is

progressive loss of hyaline cartilage.

Question 7

Two risk factors for OA

Answer 7

 Age (80% > 75yrs)
 Obesity
 Joint abnormality

Question 8

Two symptoms of OA

Answer 8

 Pain: worse with movement, background rest/night pain,
worse @ end of day.
 Stiffness: especially after rest, lasts ~30min (e.g. AM)
 Deformity
 ↓ ROM (range of motion)

Question 9

Two signs of OA?

Answer 9

 Bouchard’s (prox), Heberden’s (dist.) nodes
 Thumb CMC squaring
 Fixed flexion deformity

Question 10

Three general approaches to OA management?

Answer 10

Conservative
medical
surgical

Question 11

Two conservative treatments of OA?

Answer 11

physio
walking aids, supportive footwear
lose weight
tailored exercise, rest

Question 12

Two medical approaches for OA?

Answer 12

Analgesia
Joint injection (steroids and local)

Question 13

Two surgical approaches to OA?

Answer 13

 Arthroscopic washout: esp. knee.
-Trim cartilage, remove foreign bodies.
 Arthroplasty: replacement (or excision)
 Osteotomy: small area of bone cut out.

Question 14

One modifiable risk factor for OA?

Answer 14

trauma!!!. muscle weakness, high impact activities

Question 15

Two non modifiable risk factors for OA

Answer 15

female, age, genetics, congenital, acquired- infection, dysplastic

Question 16

Two complications of arthropathy?

Answer 16

infection, wound healing problems, dislocation (hip and knee), leg length discrepancy, fracture, loosening of joint

Question 17

What are specific signs of OA in the hand?

Answer 17

heberdens nodes- DIP, bouchards nodes- PIP, weak grip, reduced range of motion

Question 18

You come across a patient with swollen, painful, and stiff distal interphalangeal joints. What is the term given to describe these joints and in which condition are they found?

Answer 18

OA, herbeden’s nodes