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Medicine Unit 5 > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

arthritis definition

A

term used to mean any disorder that affects joints
symptoms normally include joint pain and stiffness

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2
Q

2 main categories of arthritis

A

inflammatory
non-inflammatory

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3
Q

different types of inflammatory arthritis

A

rheumatoid arhtritis
seronegative spondyloarthropathies
crystal arthritis
septic arthritis

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4
Q

what is osteoarthritis

A

clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life
most common form

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5
Q

clinical features of osteoarthritis

A

bony swelling
muscle aasting
deformity
palpable crepitus on movement
restricted painful movement

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6
Q

radiographic features of OA

A

joint space narrowing
osteophyte
subchondral sclerosis
subchondral cysts

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7
Q

what is in the image

A

normal knee x ray

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8
Q

what does the image show

A
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9
Q

clinical term for bunion

A

hallux valgus

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10
Q

x-rays are helpful to exclude

A

fracture
pages
pseudoogut
avascular necrosis

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11
Q

x rays not helpful to exclude

A

ligament/meniscal problems
inflammatory arthritis
tumour
infection

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12
Q

NICE OA management guidelines regarding OA diagnosis

A

persistent joint pain with use
aged 45+
any morning stiffness lasting no more than half an hour
no x ray needed

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13
Q

blood test results

A

usually normal
no place in diagnosis other than investigate other diagnoses

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14
Q

aetiology of OA

A

not just one disease
multiple risk factors
differs between sites

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15
Q

pathology, what is OA

A

metabolically active dynamic repair process
affects all joint tissues

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16
Q

some joint features of OA

A

cysts
cartilage fibrillation and erosion
marginal osteophyte
subchonral sclerosis
periosteal ostephyte
muscle atrophy
bursitis
capsular fibrosis
osteochondral body
synovial hyperplasia
enthesopathy

17
Q

tissue loss

A

cartilage micro fracture
fragments break off
pitting and abrasion of cartilage
localised loss of hyaline cartilage

18
Q

reactive changes

A

remodelling of adjacent bone
new bone formation
synovitis/effusion
reabsorption of necrotic fractured subchondral bone

19
Q

why do x rays not correlate with symptoms

A
20
Q

outcome of OA

A

outcome variable
progressive decline isn’t inevitable
radiographic improvement is rare
symptoms episodic
varies on site
hand improvement common

21
Q

knee rule of thirds

A

one third mild symptoms/improve
one third moderate/stay same
one third severe/progress

22
Q

different exercising to help

A

aerobic exercise
quadriceps strengthening

23
Q

how does exercise help

A

improve pain
physical function
quality of life
balance

24
Q

core management

A

education, and advice
strengthening exercise
weight loss if overweight

25
Q

drugs to manage

A

paracetamol
topical NSAIDs

26
Q

other management

A

oral NSAIDs
capsaicin
opioids
intra articular corticosteroid injections
local heat and cold applications
assistive devices
joint arthroplasty
manual therapy
transcutaneous electrical nerve stimulation
shock absorbing shoes
supports and braces

27
Q

dispelling myths in education

A

not inevitable cause of ageing
not just wear and tear
involves whole joint
decline and joint replacement isn’t inevitable, symptoms often improve
effective non-surgical treatment available
exercise

28
Q

analgesic drugs

A

adjunctive to core treatments
Paracetamol first line
topical NSAIDs considered for knee or hand OA

29
Q

what isn’t recommended for treatment

A

glucosamine
chondroitin

NICE states no evidence to support use of them in knee or hip

30
Q

what may be used instead of paracetamol or topical NSAIDs

A

oral NSAID
COX-2 inhibitor
opioids

31
Q

non-pharmacological treatment

A

hand therapy for joint protection
supports and braces
heat and cold
walking aids
footwear

32
Q

intra-articular injections

A

improve pain and function for up to 6 weeks (knee)
evidence poor quality

33
Q

joint replacement surgery

A

mainly hips and knees
symptoms having significant impact on quality of life
symptoms refractory to non-surgical treatment

34
Q

DMOADs

A

disease modifying therapies for osteoarthritis

35
Q

cartilage driven endocyte DMOAD for cartilage defects

A

proteinases inhibitors
fibroblast growth factor 18
Wnt signalling inhibitors
TGF beta
senolytic therapies

36
Q

synovitis driven end-type for synovitis

A

diacerein
IL-1, TNF alpha
tocilizumab
XT-150

37
Q

bone driven end-type for subchondral bone remodelling

A

cathepsin K inhibitor
parathyroid hormone
matrix extracellular
phosphoglycoprotein MEPE
vitamin D
bisphosphonate

38
Q

what isn’t recommended in treatment

A

arthroscopic lavage unless clear history of mechanical locking

Medicine Unit 5 (14 decks)

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