osteoarthritis Flashcards
1
Q
what
A
wear and tear of joints
not inflammatory
imbalance between cartilage being worn down and chondrocyte repair –> structural issues
2
Q
risk factors
A
obesity age occupation trauma female sex FHx
3
Q
x-ray changes
A
loss of joint space
osteophytes
subchondral sclerosis
subchondral cysts
4
Q
presentation
A
joint pain and stiffness - worsened by activity
deformity
reduced function
5
Q
commonly affected joints
A
hips knees SI joints DIPJ MCP at base of thumb wrist cervical spine
6
Q
signs in the hands
A
heberden's nodes (DIPJ) bouchards nodes (PIPJ) squaring at base of thumb weak grip reduced ROM
7
Q
what kind of joint is the carpo-metacarpal joint at base of thumb
A
saddle joint
8
Q
diagnosis
A
no Ix needed if Pt >45yrs, has activity related pain and no AM stiffness/stiff < 30mins
9
Q
Mx
A
patient education, physiotherapy, OT, orthotics
stepwise use of analgesia
I/A steroid injection
joint replacement
10
Q
stepwise use of analgesia
A
- oral paracetomol and topical NSAID/capsaicin
- oral NSAID (consider PPI)
- consider opiates - codeine, morphine
