Osteoarthritis Flashcards
Define OA
NON-inflammatory arthritis with no systemic symptoms
What are a few risk factors for OA?
Age
Obesity
Occupational hazards
With the pathophysiology of OA, what is lost?
Thinning/loss of hyaline articular cartilage
Describe the type of cartilage that is lost with OA
Type 2 collagen and proteoglycan (aggrecan)
After cartilage is lost, what occurs to the bone with OA?
Subchondral bone thickening (sclerosis) and remodeling
Mild reactive synovitis can also occur. What results and what mediates it?
Mediated by IL-1b and TNF-alpha
= synovial hypertrophy and effusion
What locations are the most commonly affected by OA?
- Cervical and Lumbar spine
- Hips and knees
- 1st CMP (thumb), PIP and DIP joints
- 1st MTP joint
What locations are the most commonly affected by OA?
- Cervical and Lumbar spine
- Hips and Knees
- 1st CMC joint (thumb), PIP, DIP
- 1st MTP joint
Herbedens Nodes
DIP bony prominences
Bouchards Nodes
PIP bony prominences
OA affects what type of joints?
Weight bearing
Often used joints
What type of onset and progression does OA have?
Insidious onset of intermittent symptoms
–> more persistent and severe as time goes on
Describe some symptoms of OA
- Pain worse with activity and relieved by rest
- Crepitus and decreased ROM
- Cool effusion
- Joint instability
Laboratory results with OA?
Usually NORMAL
How does the joint fluid look with OA?
Clear with good viscosity and WBCs < 2000
List 5 things you could see on an OA radiograph
- Space narrowing
- Subchondral sclerosis/thickening
- Osteophytes and marginal lipping
- Bone cysts
- Joint mice
List 5 things you could see on an OA radiograph
- Space narrowing
- Subchondral sclerosis/thickening
- Osteophytes and marginal lipping
- Bone cysts
- Joint mice
How does the subchondral sclerosis/thickening look on radiograph?
White
What joints are usually affected with Erosive OA?
DIP and PIP
Erosive is more common in _____. What symptom is atypical?
More common in women
= More PAIN than typical
What sign on radiograph will indicate an Erosive OA?
Seagull appearance
– central erosions!
DISH stands for?
Diffuse Idiopathic Skeletal Hyperostosis
What is DISH?
Calcification and ossification of spinal ligaments and enthesis (attachments of tendons/ligaments)
DISH is more common in who and where?
Men – T spine!
Ossifications of at least 4 contiguous vertebral levels on the right side of the spine most commonly is?
DISH
- Diffuse Idiopathic Skeletal Hyperostosis
