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Finals: Medicine > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Define osteoarthritis

A
  • Thought to be natural “wear and tear” in the joints over time
  • Progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of bony spurs and cysts at the margins of the joints
  • Characterised by progressive synovial joint damage resulting in structural changes, pain and reduced function
  • Typically, a progression of joint pain and stiffness over months/years
  • Most common form of arthritis
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2
Q

Which arthritis is thought to be natural “wear and tear” in the joints over time

A

Osteoarthritis

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3
Q

What is the main risk factor for osteoarthritis

A

Obesity

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4
Q

Name some risk factors for osteoarthritis

A

Obesity

Age – more common over 45 years old

Occupation

Previous trauma to joints

Post-menopausal women

Family history

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5
Q

What is the key clinical feature of osteoarthritis

A

Joint pain and stiffness

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6
Q

The joint pain and stiffness associated with osteoarthritis tend to:

a) worse on rest and better with activity
b) worse with activity and better with rest

A

b) worse with activity and better with rest

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7
Q

Heberden’s nodes are associated with what kind of arthritis

A

Rheumatoid arthritis

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8
Q

Bouchard’s nodes are associated with what kind of arthritis

A

Rheumatoid arthritis

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9
Q

What are the two nodes associated with rheumatoid arthritis

A

Heberden’s nodes

Bouchard’s nodes

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10
Q

What joints are affected by Heberden’s nodes

A

Distal interphalangeal (DIP) joint

Think HD like in High Definition

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11
Q

What joints are affected by Bouchard’s nodes

A

Proximal interpharyngeal (PIP) joint

Remember it as BP like Blood Pressure

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12
Q

What joints are commonly affected by osteoarthritis

A

Large, weight bearing joints e.g. knee, hip and lumbar spine

The distal and proximal interphalangeal joints (DIP and PIP) of the hands

Sacro-iliac joints

First carpometacarpal joint (CMC) of the thumb

Cervical spine

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13
Q

Is morning stiffness associated with osteoarthritis?

A

No

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14
Q

Osteoarthritis is a clinical diagnosis and is made up of three components .

What are these three components

A

Over 45 year old

Typical activity related pain

No morning stiffness or stiffness lasting < 30 minutes

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15
Q

What is the gold standard investigation for osteoarthritis

A

X-Ray

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16
Q

What are the 4 X-Ray features of osteoarthritis

A

Mnemonic “LOSS”

L - Loss of joint space

O- Osteophytes

S - Subchondral cysts

S - Subarticular sclerosis

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17
Q

The management of osteoarthritis is a combination of pharmacological and non-pharmacological approaches.

Name some non-pharmacological approaches in managing osteoarthritis

A

Patient education

Advice on lifestyle changes, particularly weight loss to reduce the load on the joint

Physiotherapy to improve strength to support the joint

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18
Q

The management of osteoarthritis is a combination of pharmacological and non-pharmacological approaches.

Name the 3 potential pharmacological approaches in managing osteoarthritis

A

Analgesia

Intra-articular joint injection

Surgical management

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19
Q

What is the 1st line analgesia used in managing osteoarthritis

A

Paracetamol

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20
Q

Paracetamol is the 1st line choice for analgesic relief in managing osteoarthritis.

What are other potential analgesic choices

A

Topical NSAIDs or topical capsaicin, in particular for knee and hand osteoarthritis

Oral NSAIDs (+ PPI cover)

Consider opiates – can have significant side effects and don’t work great for chronic pain as the patients become dependent without benefitting from the analgesic effects

Opioid analgesia, after considering the risks, can be offered

21
Q

What are the two potential risks for intra-articular joint injection

A

Septic arthritis (very rare)

Avascular necrosis

22
Q

Describe the effect intra-articular joint injection has on managing osteoarthritis

A

Provides a temporary reduction in inflammation and improve symptoms

Short lived effects

23
Q

What is the name for joint replacement surgery

A

Arthroplasty

24
Q

When is joint replacement surgery (arthroplasty) indicated in managing osteoarthritis

A

Considered in severe cases, where the patients quality of life is impacted and it has not responded to non-surgical options

25
Q

Describe the aetiology of osteoarthritis

A

Mechanically driven – “wear & tear”

localised loss of cartilage

remodelling of adjacent bone

associated inflammation

26
Q

Describe the aetiology of rheumatoid arthritis

A
27
Q

What gender is osteoarthritis more common in

A

Similar incidence in men and women

28
Q

What gender is rheumatoid arthritis more common in

A

More common in women

29
Q

What age is osteoarthritis more common in

A

Seen most commonly in the elderly

30
Q

What age is rheumatoid arthritis more common in

A

Seen in adults of all ages

31
Q

What joints are typically affected in osteoarthritis

A

Large weight-bearing joints (hip, knee)

Carpometacarpal joint

DIP and PIP joints

32
Q

What joints are typically affected in rheumatoid arthritis

A

MCP and PIP joints

DIP if often spared

33
Q

In which arthritis is the pain worse with use

a) osteoarthritis
b) rheumatoid arthritis

A

a) osteoarthritis

34
Q

In which arthritis is the pain better with use

a) osteoarthritis
b) rheumatoid arthritis

A

b) rheumatoid arthritis

35
Q

In which arthritis is the pain improves with rest

a) osteoarthritis
b) rheumatoid arthritis

A

a) osteoarthritis

36
Q

In which arthritis is the pain worse with rest

a) osteoarthritis
b) rheumatoid arthritis

A

b) rheumatoid arthritis

37
Q

In which arthritis is the symptoms commonly affect unilateral joints:

a) osteoarthritis
b) rheumatoid arthritis

A

a) osteoarthritis

38
Q

In which arthritis is the symptoms commonly affect bilateral joints:

a) osteoarthritis
b) rheumatoid arthritis

A

b) rheumatoid arthritis

39
Q

In which arthritis is associated with systemic upset:

a) osteoarthritis
b) rheumatoid arthritis

A

b) rheumatoid arthritis

40
Q

In which arthritis does not have systemic upset associated with it:

a) osteoarthritis
b) rheumatoid arthritis

A

a) osteoarthritis

41
Q

What are the three joints affected by osteoarthritis

A

PIP

DIP

Carpometacarpal joint

42
Q

What are the two joints affected by osteoarthritis

A

DIP

MCP

43
Q

Where are subchondral cysts located

A

Deep to the articular surfaces of the joints

44
Q

Where are peri-articular erosions located

A

In the joint margins

45
Q

Subchondral cysts is an unique x-ray change of which arthritis:

a) Osteoarthritis
b) Rheumatoid arthritis

A

a) Osteoarthritis

46
Q

Peri-articular erosions is an unique x-ray change of which arthritis:

a) Osteoarthritis
b) Rheumatoid arthritis

A

b) Rheumatoid arthritis

47
Q

Presence of osteophytes is an unique x-ray change of which arthritis:

a) Osteoarthritis
b) Rheumatoid arthritis

A

a) Osteoarthritis

48
Q

Subchondral sclerosis is an unique x-ray change of which arthritis:

a) Osteoarthritis
b) Rheumatoid arthritis

A

a) Osteoarthritis

49
Q

Describe the x-ray feature of subchondral sclerosis (x-ray feature of osteoarthritis)

A

Seen as increased density of the articular surface

Finals: Medicine (91 decks)

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