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OCS Preparation > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

What happens to fat tissue in the joint space after immobilization in patients with OA?

A

Increase in fibro-fatty build up in the joint space.

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2
Q

What are some of the results of excessive loading of articular cartilage?

A

Damage to collagen fiber network

Proteoglycan wash out

Decreased ability to respond to compressive and shear forces

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3
Q

In regards to OA which joint is the most frequently affected and source of complaint?

A

Hands

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4
Q

Four factors which contribute to joint inflammation

A

Abnormal mechanical loading

Obesity

Genetics

Aging

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5
Q

What are the 4 stages of changes in the cartilage structure as the degenerative process progresses?

A

Increased water and decreased proteoglycans

Fibrillation, fissuring, and erosion

Calcification/sclerosis of subchondral bone

Chondrocyte proliferation, hypertrophy, and apoptosis

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6
Q

What is represented in this image?

A

Bone marrow lesions

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7
Q

What are the common changes in bone structure during the later stages of OA?

A

Sclerosis (hardening) and cyst formation to the subchondral bone

Bone marrow lesions

Osteonecrosis

Bone attrition (reduction)

Joint deformity

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8
Q

What is the most likely source of pain in the OA?

A

Synovium

Bone

Nerves

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9
Q

What is the are the things indicated by the arrows and how does that influence OA?

A

That is infiltration of fragments of bone or cartilage into the synovium

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10
Q

What did Duncan’s 2008 study show in regards to severity of OA and severity of pain?

A

There is a strong correlation between pain and severity of OA

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11
Q

What are some of the characteristics of Kelgren and Lawrence Level I OA?

A

Minute osteophytes

Normal joint space

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12
Q

What are some of the characteristics of Kelgren and Lawrence Level II OA?

A

Identifiable osteophytes

Joint space still maintained (mild)

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13
Q

What are some of the characteristics of Kelgren and Lawrence Level III OA?

A

Moderate reduction in joint space

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14
Q

What are some of the characteristics of Kelgren and Lawrence Level IV OA?

A

Severe reduction in joint space (severe)

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15
Q

What is the specificity and sensitivity for Altman’s clinical classification for Knee OA?

A

Sensitivity 89%

Specificity 88%

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16
Q

A recent Cochrane review should some results of land based exercise for OA. What are those results?

A

Exercise resulted in short term pain relief sustained for 2-6 months.

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17
Q

What are the precaution for rTSA?

A

Internal rotation with adduction and extension

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18
Q

The condition of which muscle determines the external rotation following a rTSA?

A

Teres minor

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19
Q

What is the rate of progression of patients with a negative ER lag sign following a rTSA

Wha is the functional elevation expected?

A

Quicker progression in terms of arm strength.

Functional elevation of 105º

20
Q

What are the main risk factors for hip OA?

A

Age

Previous hx of developmental disorders (developmental dysplasia, congenital dislocation, Legg-Calve-Perthes, Slipped Capital Femoral Epiphysis)

Trauma

High impact athletes (football, hockey)

Obesity (conflicting)

21
Q

What are the imaging ranges of distance for OA spacing in Hip OA?

A

Normal: 3-5mm

Significant change <0.5mm change

Moderate OA < 2.5mm (osteophytes likely present)

Severe OA: < 1.5mm (sclerotic hardening)

22
Q

What are the clinical diagnostic criteria for hip OA?

A

Hip pain

Erythrocyte sedimentation rate ≤20mm/hr

Pain on internal hip rotation

AM stiffness

Age greater than 50 years

23
Q

A difference of how many degrees between legs of internal rotation of the hip is considered pathological?

A

15 degrees

24
Q

What is the pattern of hip ROM limitation from more limited to less limited?

A

Internal rotation

Abduction

Flexion

25
Q

What are the 5 items in Sutlive CPR for the diagnosis of hip OA?

A

Painful squatting

Painful flexion

Scour test that produces groin pain

Painful extension

IR <25º

26
Q

What manual therapy maneuver is applied in this picture?

A

Anterior glide of the hip joint.

27
Q

What manual therapy maneuver is presented here?

A

Posterior hip glide.

28
Q

What maneuver is being presented here?

A

Lateral distraction of the hip.

29
Q

Which maneuver is this and how much force do you need to be effective?

A

Long axis distraction of the hip

70lb

30
Q

What is this test assessing?

A

Knee flexion with adduction.

Externally rotating and adducting the tibia.

31
Q

What is this test assessing?

A

Knee flexion

Tibia IR and abduction

32
Q

What effects are expected with tibia internal rotation in various decrees of knee flexion?

A

This motion can add more movement of the tibia without increasing any symptoms to the knee.

33
Q

Wha is the intension of this maneuver?

A

Promote knee extension

34
Q

What maneuver is this?

A

Medial patellar glide.

35
Q

What maneuver is this?

A

Lateral patellar glide.

36
Q

What is the following technique?

A

Patellar rotation

37
Q

What technique is this?

A

Patellar caudal glide

38
Q

What maneuver is this?

A

Patellar superior glide

39
Q

What maneuvers is this?

A

Fibular glides - Posterior

40
Q

What maneuver is this?

A

Anterior tibial glide.

41
Q

What is this maneuver testing

A

Quad flexibility

42
Q

Besides obesity, female gender, and poor muscular strength what other condition is also associated with symptomatic knee OA?

A

Lower educational level.

43
Q

What medication is recommended for patients with mild to moderate pain in knee OA?

A

Acetaminophen (Tylenol)

44
Q

Which modality is indicated in the case of knee OA?

A

TENS

45
Q

Which kind of injections have demonstrated good results for patients with knee OA?

A

Hyaluronate

(More effective than corticosteroids)

46
Q

Which kind of surgery is indicated for medial or lateral compartment pain?

A

Unicompartmental knee arthroplasty per Zhang et all 2008

47
Q

Is ACL morphological changes shown on MRI in the presence of knee OA per Altman?

A

No.

OCS Preparation (7 decks)

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