Osteoarthritis Flashcards
what is osteoarthritis
aka degenerative joint disease “arthritis”
most common form of joint disease
articular cartilage loss (joint space narrowing), osteophyte formation
What are risk factors for OA
non-modifiable
- genetics/FH, age and gender (f), ortho deformities
modifiable
- joint trauma, frequent high impact activity, mechanical work stress (bending, lifting), obesity
what is the pathophysiology of OA
progressive degeneration of articular cartilage - cartilage loss
- secondary to chondrocyte dysfunction - inflammatory cytokine release
- also leads to reactive bone formation - sclerosis, osteophytes
associated changes in synovial fluid make up - becomes less lubricating
What is the presentation of OA
insidious onset of joint pain (asymmetric) - particularly weight bearing activities, relieved with rest
associated symptoms: stiffness AM or with inactivity (<15) , mild edema/effusions, reduced ROM, joint line tenderness, possible deformity (varus of knee, heberden nodes, bouchard nodes)
What is Heberden node
DIP joint nodules
what is Bouchard node
PIP joint nodules
What is the first line of workup for OA
x-rays (weight bearing)
assess for joint space narrowing
osteophyte formation
subchondral sclerosis
subchondral scerlosis
subchondral cysts
what is the conservative treatments for OA
conservative measures: exercise/PT, weight loss, symptomatic splinting/bracing, assistive devices, glucosamine/chondroitin supplements
what are the pharmacologic options for OA tx
acetaminophen first line
NSAIDS more effective, more SE (oral vs topical)
what are the intra-articular injection options for OA treatment
corticosteroids
Hyaluronic acid (viscosupplements)
what is the last treatment option for OA patients
joint replacement/arthroplasty
what are the indications for arthroplasty
failure of conservative management
significant functional impairment
loss of ROM (hard to get back)
