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BRS MUSCULOSKELETAL And RHEUM > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

What is the WHO definition of OA?

A

A long term chronic disease characterized by the destruction of cartilage in joints which results in bones rubbing together creating stiffness, pain and impaired movement

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2
Q

What is chondral cartilage?

A

Cartilage which lies on the surface of the bones to allow low friction movements

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3
Q

OA is a degenerative disease of what cartilage?

A

Chondral Cartilage

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4
Q

When does inflammation occur in OA relative to RA?

A

Inflammation occurs late in the onset of disease compared to RA

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5
Q

What are the main inflammatory cytokines involved in OA?

A

TNF-alpha and IL-1Beta

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6
Q

What are two examples of proteinases?

A

Matrix Metalloproteins and aggrecanases

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7
Q

What is the effect of inflammatory cytokines like TNF on the articular cartilage membrane?

A

TNF increases the synthesis of proteinases and other catabolic factors which degrade the articular cartilage membrane

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8
Q

What factors can lead to endogenous predisposition OA?

A

Age, gender, genetics and high BMI

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9
Q

What external factors can increase the risk of OA?

A

Trauma and overload

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10
Q

How do subchondral cysts form?

A

When inflammatory cells eat away at bone

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11
Q

How does loss of joint space lead to sclerosis?

A

When osteoblasts try and make more bone to compensate for the loss of bone and it thickens

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12
Q

Which type of cartilage is broken down by Matrix Metallo Proteinases?

A

Hyaline articular cartilage

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13
Q

What causing the caving in of the bones?

A

When the lateral sides of the knee cartilage has been degraded

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14
Q

Describe the cycle which is involved in the development of OA?

A

Joint pain -> Lead to limited mobility -> Lack of physical activity -> Leads to obesity -> Increased pressure on joints

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15
Q

What are the main locations where OA can be found?

A

Knee, Hip, Spine, Fingers

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16
Q

What affect does having a family history of Osteoarthritis have on the age on onset of OA?

A

it causes a left shift in the curve - onset is earlier

17
Q

How does the pain of OA change throughout the day?

A

gets worse throughout the day

18
Q

How long does morning stifness/pain last with OA?

A

Minimal - less than 20 minutes

19
Q

Compare the timing of pain between OA and RA?

A

OA gets worse throughout the day and RA is worse in the morning and gets better throughout the day

20
Q

What is crepitus?

A

When you get crunching of your bones as they are rough surface on rough surface

21
Q

What happens to a patients range of motion when they suffer from OA?

A

Range of motion is limited

22
Q

What are the four stages of assessment for OA?

A

Look
Feel
Move
Special Tests

23
Q

What is the bone deformity commonly seen in OA patients when standing?

A

Valgus deformity - this is where the lateral sides of the articular cartilage are further degraded than the medial resulting in the inwards collapse of the legs

24
Q

What is the bulge test for knee effusion?

A

The dimple of fluid will disappear when it gets pushed away and bulge again when the fingers are moved

25
Q

What is the name given to fluid swellings in the knee joints?

A

Fluid effusion

26
Q

What are the two things that should be felt for during an OA assessment?

A

Knee effusion and warmth which would indicate inflammation

27
Q

What is a lab tests which can be done to test for OA?

A

Check for cartilage degradation products in the serum and joint fluid

28
Q

What are four radiological changes seems with OA?

A

LOSS

Loss of joint space
Osteophytes
sclerosis
subchondral cysts

29
Q

What are injections which can be given to manage OA?

A

Steroid, lubrication gel, platelet rich plasma, hyaluronic acid

30
Q

What are some conservative OA management strategies?

A

Weight loss, analgesics, physiotherapy, walking aids, avoiding exacerbating activity

31
Q

What operative procedure is done if OA is found in the knee?

A

Knee replacement

32
Q

What operative procedure is done if OA is found in the wrist?

A

Denervate wrist

33
Q

What are some signs and symptoms which patients might present with if they have OA?

A

Swollen joint, ballotable effusion, warmer indicating inflammation, limited range of motion

34
Q

What are the seven elements of the flow chart which outlines the progression of injury to OA?

A

Injury -> meniscal tear -> surgery / removal -> increased pressure in the knee -> articular cartilage wear -> loss of joint space -> OA

35
Q

Which nodes are found at the DIP joints?

A

Heberdens nodes

36
Q

Which nodes are found at the Proximal Interphalangeal Joints?

A

Bouchards

37
Q

Between DIP and PIP joints, which are more likely to be found in OA?

A

DIP

BRS MUSCULOSKELETAL And RHEUM (17 decks)

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