Osteoarthritis - 125

Question 1

What term describes pain that arises from joints?

Answer 1

Arthralgia

Question 2

What is arthritis?

Answer 2

Objective joint abnormality

Question 3

How many joints must be infected for arthritis to be classed as polyarthritis?

Answer 3

4 or more

Question 4

What is the term to describe tendon sheath inflammation?

Answer 4

Tenosynovitis

Question 5

What is myositis?

Answer 5

Inflammatory disease of a muscle

Question 6

What is ankylosing spondylitis?

Answer 6

A chronic inflammatory disease of the axial skeleton -> so has central clinical manifestations

Question 7

What is osteoarthritis?

Answer 7

A group of mechanical abnormalities involving the degradation of joints, including articular cartilage and subchondral bone.
* Simple terms - OA is joint failure

Question 8

Where are clinical manifestations of OA?

Answer 8

Peripherally

Question 9

What is the most common joint disorder?

Answer 9

Osteoarthritis

Question 10

Name some risk factors for OA

Answer 10

Hereditary, obesity, hypermobility, smoking

Question 11

What is normal chondrocyte function dependent on?

Answer 11

Intermittent joint loading

Question 12

Describe the pathological changes in OA

Answer 12

Focal destruction of cartilage, sclerosis of subchondral bone, subchondral cysts, osteophytes

Question 13

What investigations would be done on a patient with suspected OA?

Answer 13

History, examination and X-ray

No lab testing is diagnostic

Question 14

What might you see on the x ray of a patient with OA?

Answer 14

Osteophytes, joint space narrowing, subchondral sclerosis, subchondral cysts

Question 15

How can OA be treated?

Answer 15

Conservative management: weight loss, exercises, supportive devices
Drug treatment: NSAIDs, paracetamol, mild opiods, intra-articular corticosteroids
Surgery

Question 16

What does Wolff’a law state?

Answer 16

The shape and structure of bones is a reflection of their mechanical loading history -> this now includes MSK tissues too.

Question 17

What kind of fractures can compression forces lead to?

Answer 17

vertebral

Question 18

What kind of fractures are tensile forces on bone associated with?

Answer 18

Avulsion fractures (tendon pulls off a small chunk of bone)

Question 19

What acts as springs in locomotion by storing energy when stretched and releasing it to complement muscle force on recoil?

Answer 19

Tendons

Question 20

As forces increase, what happens to ligaments?

Answer 20

They become stiffer

Question 21

What are the 4 major properties of skeletal muscle?

Answer 21

Irritability, contractability, extensibility, elasticity

Question 22

What does a muscle synergist do?

Answer 22

Prevents the unwanted movements that would be produced if the prime movers acted alone

Question 23

Describe the 3 parts to muscle mechanics

Answer 23

1) swing - moves angle of mobile bone
2) shunt - compresses the bones together
3) spin - twists mobile bone along its long axis

Question 24

Name 2 factors that limit skeletal movement and how they are different

Answer 24

Passive insufficiency -> doesn’t allow movement at both joints simultaneously
Active insufficiency -> inability of a muscle to contract by more than a fixed amount

Question 25

PTH is produced in response to what change in Calcium?

Answer 25

Produced when calcium is LOW

Question 26

How does PTH act to increase calcium levels?

Answer 26

• It’s absorbed in the intestine by Vit D
• Resorbed from bone, increased osteoclast activity
• Decreased excretion due to increased absorption in DCT

Question 27

What is the role of calcitonin?

Answer 27

To decrease Calcium levels

Question 28

How does calcitonin work?

Answer 28

Produced by C cells in thyroid.

Acts to inhibit bone resorption by inhibiting osteoclasts

Question 29

What type of cartilage lesion might heal spontaneously? Why?

Answer 29

Osteochondral defect.

Blood supply!

Question 30

What defines a chrondral cartilage lesion? Will it heal spontaneously?

Answer 30

Chondral Defect – Lesion entirely within cartilage, doesn’t penetrate to bone.
Won’t heal spontaneously as no blood supply