Osteoarthritis

Question 1

What is the Most common arthiritis?

Answer 1

Osteoarthritis

Question 2

What is osteoarthritis?

Answer 2

Non inflammatory, ‘wear and tear’ , degenerative disease

Question 3

What joints does it affect?

Answer 3

synovial joints

Question 4

what are the risk factors for the disease?

Answer 4

age (affects WOMEN 50+ more)
Obesity
Sports/occupation
genetic (COL2A1 = genetic predisposition)

Question 5

What is the pathology behind osteoarthritis?

Answer 5

Imbalance in cartilage break/worn down > repair (by chondrocytes)

High chondrocyte metalloprotinase (MMP) secretion - which breaks down protein such as collagen

Degrades T2 collagen and causes cysts

Bone attempts to overcome this with T1 collagen: ABNORMAL BONY GROWTHS (osteophytes) + remodelling

Question 6

Symptoms of osteoarthritis

Answer 6

Transient (<30 min) morning pain
Pain is worse as day goes on
Worse during movement and relieved by rest

Bouchard and Haberdens nodes on fingers (bone swellings make finger joints wider)
-Asymmetrical, hard, non inflamed joint
-Typically most stressed joint in body (base of thumb/big toe, hip/knee)
- no extra articular symptoms

Question 7

Diagnosis of osteoarthritis

Answer 7

X Ray - LOSS
Loss of joint space
Osteophytes
Subchondral Cysts (fluid filled holes in bone)
Subchondral sclerosis (high density of bone along joint line)

Bloods NORMAL

Question 8

Treatment of osteoarthritis

Answer 8

Lifestyle changes, weight bearing, physio

Analgesia (painkillers):
1. Paracetamol, Topical NSAID (ibuprofen) / Capsaicin
2. Oral NSAID + PPI (Naproxen and ibuprofen)
3. Opiates (codeine + morphine)

Last resort = Surgery
Arthroplasty - hip/knee replacement

*Also intra articular steroid injections