Osteoarthritis Flashcards
What is osteoarthritis?
Breakdown of the joint cartilages meaning the bones rub together. This presents with pain and stiffness in the joints
Known as wear and tear arthritis
What is the thought pathophysiology or osteoarthritis?
An imbalance between the articular cartilage wearing down and the chondrocytes repairing it. The bones then rub against each other leading to remodelling changes.
What are some risk factors for osteoarthritis?
Obesity Age Occupation - manual labour, extreme sports Trauma Female Family history
Which joints are commonly affected by osteoarthritis?
Hips Knees Sacro-iliac joints Distal - interphalangeal joints (DIPs) Carpometacarpal joint at base of thumb Wrist Cervical spine
What are the X-ray signs of osteoarthritis?
(L)oss of joint space
(O)steophytes
(S)ubarticular sclerosis (increased bone density)
(S)ubcondral cysts (fluid filled holes in the bone)
What are the common symptoms of osteoarthritis?
Stiffness in joint (commonly unilateral)- generally worse with movement and at the end of the day
Pain in joint
Crepitus / grinding
Restricted range of movement
What signs in the hands indicate osteoarthritis?
Heberden's nodes (DIP joint swelling) Bouchards nodes (PIP joint swelling) Squaring at the base of the thumb (carpometacarpal joint) Weak grip Reduced range of motion
How is osteoarthritis managed?
Weight loss Physiotherapy Occupational therapy Analgesia (paracetamol, NSAIDS, opiates) Steroid injections (only work temporarily) Joint replacement
What is often co prescribed with an NSAID and why?
A proton pump inhibitor such as lansoprazole to decrease risk of gastritis and peptic ulcers.
What are some side effects of NSAIDS?
GI side effects - gastritis and peptic ulcers
Renal - AKI
Cardio - hypertension, heart failure, MI
Exacerbates asthma
What are some differentials for osteoarthritis?
Inflammatory arthropathies - rheumatoid arthritis Gout Septic arthritis Fractures Bursitis Malignancy - primary or metastatic
What gait may be seen in someone with osteoarthritis of the hip?
Antalgic - due to the pain
- looks like limping
What are some differentials for lateral hip pain?
Osteoarthritis of the hip
Trochanteric bursitis
Gluteus medius tendinopathy
Femoral neck fracture
