Osteoarthritis Flashcards
what is osteoarthritis
Osteoarthritis (OA) is a degenerative joint disorder; prevalence increases with age- cartilage destruction exceeds repair
very sudden, insidious onset of joint pain and stiffness
what joints does osteoarthritis affect the most
weight bearing, large joints such as the knee, hip and lumbar spine
can also occur in the distal and proximal interphalageal joints of the hands
summarise the pathogenesis of osteoarthritis
Synovial joint cartilage destruction
Eventually, there is loss of joint volume due to altered chondrocyte activity
Patchy chronic synovial inflammation and fibrotic thickening of joint capsules
what can cause secondary osteoarthritis
Developmental abnormalities (e.g. hip dysplasia)
Trauma (e.g. previous fractures)
Inflammatory (e.g. rheumatoid arthritis, gout, septic arthritis)
Metabolic (e.g. haemochromatosis, acromegaly)
what are some risk factors for developing osteoarthritis
obesity and repetitive trauma to joints
what is the difference between osteoarthritis and inflammatory diseases
in osteoarthritis; pain worse with movement, worse at the end of the day and not much morning stiffness
inflammatory diseases; pain improves with movement, worse in the mornings and morning stiffness is prolonged
what are some presenting symptoms of osteoarthritis
joint pain and discomfort,
stiffness during rest,
difficulty with certain movements,
feelings of instability,
restriction walking, climbing stairs and doing manual tasks
systemic features are usually absent
signs on physical examination
local joint tenderness,
bony swellings along joint margins (HEBERDENS NODES AND BOUCHARDS NODES)
pain during joint movement, joint effusion and restriction of RoM
where are heberdens nodes found
distal interphalangeal joint
where are bouchards nodes found
proximal interphalangeal joint
what investigation will be done
X-ray of affected joint/ joints
what will be the x-ray features
X-ray findings mneumonic for osteoarthritis
LOSS
Loss of joint space
Osteophytes
Subchrondral cysts
Subarticular sclerosis
what 3 categories can you split management into
conservative, medical and surgical
conservative management of osteoarthritis
Weight loss and aerobic exercise are effective at reducing pain and maintaining joint function. Weight bearing exercise should be avoided however as it can accelerate the progression of the disease.
Physiotherapy and occupational therapy input help to improve a patient’s gait, mobility and independence, and walking aids may be useful.
pharmacological treatment of osteoarthritis
analgesia (NSAIDs)
intra-articular steroid injections in more severe cases
