Osteoarthritis Flashcards

1
Q

Define osteoarthritis

A

degenerative joint disease occurring primarily in elderly characterized by erosion of articular cartilage, hypertrophy of bone at margins (osteophytes), subchondral sclerosis

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2
Q

What are risk factors for developing OA?

A

age, joint location, obesity, genetic predisposition, joint malalignment, trauma, gender

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3
Q

What are the early morphologic changes in early OA?

A

1) articular cartilage surface irregularity;
2) superficial clefts w/in tissue
3) altered proteoglycan distribution

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4
Q

What are the late morph changes in late OA?

A

1) deepened clefts,
2) increase in surface irregularities;
3) articular cartilage ulceration (exposes underlying bone)

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5
Q

How do osteophytes form?

A

chondrocytes form clusters or clones in attempt at self repair then marginal osteophytes can form

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6
Q

What family of proteases degrades the joint?

A

MMPs degrade proteoglycans (aggrecanases) and collagen (collagenases)

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7
Q

What causes secondary OA?

A

suboptimal repair response of normal articular cartilage to injury

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8
Q

What are the mediators of OA?

A

IL-1B;

TNF

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9
Q

What is the relationship of Nitric oxide and OA?

A

major catabolic factor produced by chondrocytes in response to pro-inflammatory cytokines

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10
Q

Expression of what factor is increased in OA chondrocytes?

A

inducible cyclooxygenase-2

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11
Q

How is cartilage affected in early OA?

A

cartilage surface becomes roughened and irregular and superficial clefts within tissue become apparent

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12
Q

Where are osteophytes typically found?

A

peripheral margins of joints at interface between cartilage and the periosteum

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13
Q

What is a cartilage contributing factor to the initiation and progression of OA?

A

reduction in cell number observed in aging cartilage and reduced synthetic capability of hypocellular cartilage

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14
Q

In early OA, what are the morph changes in cartilage?

A

water content increases causing swelling and alteration of mechanical properties

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15
Q

In later OA, what are the morph changes?

A

type I collagen concentration w/in ECM increases and proteoglycan concentration falls to 50% or less than normal

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16
Q

What is the first irreversible step in OA? why?

A

degradation of collagen bc it reduces mechanical properties of cartilage

17
Q

What is the most important step/factor in OA?

A

MMP-13 => degrades type II collagen and expression is increased in OA

18
Q

What degrades aggrecan in OA?

A

MMP and ADAMTS-4

19
Q

Oxidative injury caused by inflam cytokines, IL-1B and TNFa in OA increase what?

A

premature chondrocyte senescence

20
Q

What is a mechanoreceptor on chondrocytes that can sense and respond to mechanical stimuli?

A

alpha-5-Beta-1

21
Q

What is responsible for the pain and restriction of joint movement in OA?

A

osteophytes

22
Q

Early OA causes sclerosis of subchondral bone via what mechanism?

A

increased remodeling and hardening of subchondral bone