Osteoarthritis

Question 1

Osteorarthritis is a degenerative disease, occurring primary in the elderly, what is it characterized by?

Answer 1

Erosion of the articular cartilage, hypertrophy of the bone at margins (osteophytes), subchondral sclerosis, and a range of biochemical and morphologic alterations of the synovial membrane and joint capsule

Question 2

What are the risk factors for osteoarthritis?

Answer 2

Age, joint location, obesity, genetic predisposition, joint malalignment, trauma, and gender

Question 3

What are the morphologic changes in early OA?

Answer 3

Articular cartilage surface irregularity, superficial clefts within the tissue, and altered proteoglycan distribution

Question 4

What are the morphologic changes in late OA? What do chondrocytes do here?

Answer 4

Deepened OA, increase in surface irregularities, eventual articular cartilage ulceration which exposes underlying bone; chondrocytes form clusters or clones in an attempt to self-repair and marginal osteophytes can form.

Question 5

The MMP family of proteinases do what?

Answer 5

Degrade proteoglycans (aggrecanases) and collagen (collagenases)

Question 6

Suboptimal repair response of normal articular cartilage due to injury results in?

Answer 6

Secondary OA

Question 7

What senses and responds to mechanical and physicochemcial stimuli via several regulatory pathways?

Answer 7

Chondrocytes

Question 8

What two mediators are classically associated with inflammation during the course of OA

Answer 8

IL-1beta and TNF

Question 9

NO is produced by inducible isoform of SO synthase; what role does this play in OA?

Answer 9

A major catabolic factor produced by chondrocytes in response to proinflammatory cytokines

Question 10

Expression of what is increased in OA chondrocytes?

Answer 10

COX2

Question 11

What kind of inflammation occurs in osteoarthritic synovial tissues and what does it do?

Answer 11

Low grade; contributes to disease pathogenesis

Question 12

Most current treatment of OA aims to?

Answer 12

Improve the signs and sxs

Question 13

How common is OA and what does it most commonly affect?

Answer 13

It is the most common form of arthritis and commonly affects hands, hips, knees, spine, and feet

Question 14

OA can be defined in what 3 ways?

Answer 14

Radiographically, clinically, or symptomatically

Question 15

What is becoming a more sensitive measure of damage from OA?

Answer 15

Improved imaging and molecular biomarkers; definitions may change in OA

Question 16

What limitations contribute substantially to the disability seen in OA?

Answer 16

Pain and functional limitations

Question 17

T/F Mortality is increased in individuals with OA compared to general populations?

Answer 17

True

Question 18

Is OA the most common form of arthritis?

Answer 18

Yes

Question 19

What is the most common sx of OA?

Answer 19

Pain

Question 20

Management of OA should include?

Answer 20

Individualization, accounting for factors such as sources of pain and extent of accompanying inflammatory features

Question 21

What are the nonpharmacologic interventions for OA?

Answer 21

Weight loss, exercise

Question 22

What are pharmacologic interventions directed at in OA?

Answer 22

Symptomatic relief

Question 23

Investigation of OA is for what?

Answer 23

Potential disease-modifying interventions in OA