Osteoarthritis Flashcards
Osteorarthritis is a degenerative disease, occurring primary in the elderly, what is it characterized by?
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
What are the risk factors for osteoarthritis?
Age, joint location, obesity, genetic predisposition, joint malalignment, trauma, and gender
What are the morphologic changes in early OA?
Articular cartilage surface irregularity, superficial clefts within the tissue, and altered proteoglycan distribution
What are the morphologic changes in late OA? What do chondrocytes do here?
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.
The MMP family of proteinases do what?
Degrade proteoglycans (aggrecanases) and collagen (collagenases)
Suboptimal repair response of normal articular cartilage due to injury results in?
Secondary OA
What senses and responds to mechanical and physicochemcial stimuli via several regulatory pathways?
Chondrocytes
What two mediators are classically associated with inflammation during the course of OA
IL-1beta and TNF
NO is produced by inducible isoform of SO synthase; what role does this play in OA?
A major catabolic factor produced by chondrocytes in response to proinflammatory cytokines
Expression of what is increased in OA chondrocytes?
COX2
What kind of inflammation occurs in osteoarthritic synovial tissues and what does it do?
Low grade; contributes to disease pathogenesis
Most current treatment of OA aims to?
Improve the signs and sxs
How common is OA and what does it most commonly affect?
It is the most common form of arthritis and commonly affects hands, hips, knees, spine, and feet
OA can be defined in what 3 ways?
Radiographically, clinically, or symptomatically
What is becoming a more sensitive measure of damage from OA?
Improved imaging and molecular biomarkers; definitions may change in OA
What limitations contribute substantially to the disability seen in OA?
Pain and functional limitations
T/F Mortality is increased in individuals with OA compared to general populations?
True
Is OA the most common form of arthritis?
Yes
What is the most common sx of OA?
Pain
Management of OA should include?
Individualization, accounting for factors such as sources of pain and extent of accompanying inflammatory features
What are the nonpharmacologic interventions for OA?
Weight loss, exercise
What are pharmacologic interventions directed at in OA?
Symptomatic relief
Investigation of OA is for what?
Potential disease-modifying interventions in OA
