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ANKI Rheumatology > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

What is osteoarthritis?

A
  1. Asymmetrical degenerative synovial joint disease

2. Cartilage destruction exceeds repair, causing pain & instability

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2
Q

What is common epid of osteoarthritis?

A

Women

50-70

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3
Q

What are RF for osteoarthritis?

A
  1. Female
  2. Over 50
  3. FHx of OA
  4. Demanding sport or occupation
  5. Obesity
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4
Q

What are the most common joints affected in OA?

A
  1. knee
  2. hip
  3. hands
  4. lumbar
  5. cervical spine
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5
Q

What are classic symptoms of OA?

A
  1. Joint pain
  2. Morning stiffness: around 15 ins
  3. Stiffness worse with activity
  4. Limited range of motion
  5. Bony deformities
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6
Q

What are possible DDx for OA?

A
  1. Bursitits
  2. Gout
  3. Pseudogout
  4. RA
  5. Psoriatic arthritis
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7
Q

What investigations are used for OA?

A
  1. X ray
  2. CRP: normal
  3. ESR: normal
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8
Q

What is seen on x ray for osteoarthritis?

A
  1. Loss of joint space
  2. Osteophytes
  3. Subarticular sclerosis
  4. . Subchondral cysts
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9
Q

What is management for osteoarthritis?

A
  1. Topical analgesia e.g. capsaicin topical
  2. Intra-articular corticosteroid injection
  3. Paracetamol
  4. NSAIDs
  5. Opiod
  6. Surgery (joint replacement)
    - Exercise and weight loss
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10
Q

What are possible complications for OA?

A
  1. Functional decline and inability to perform activities of daily living
  2. Spinal stenosis in cervical and lumbar OA
  3. NSAID-related GI bleeding
  4. Effusion
  5. NSAID related renal dysfunction
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11
Q

What is primary osteoarthritis?

A

Localised (hands, knee, hip or foot) or generalised (hands and another joint)

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12
Q

What is the cause of primary osteoarthirtis?

A

wear and tear of normal joint

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13
Q

What is the usual epid of primary osteoarthritis?

A
  1. Female
  2. Obese
  3. Older
  4. Post menopausal
  5. Occupation: gardener, hairdresser
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14
Q

What is the usual causes of secondary osteoarthritis?

A
  1. Inflammatory: RH or Septic arthritis
  2. Congenital: DDH
  3. Metabolic/Endo – wilson’s or acromegaly, haemchromatosis
  4. Trauma
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15
Q

What is the cause of

secondary osteoarthritis?

A

altered joint architecture/stability acquires further damage

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16
Q

Why does osteoarthritis occur?

A

imbalance of cartilage matrix synthesis & degradation (increased catabolism or reduced formation)

17
Q

What is seen on joint aspiration for osetoarthritis?

A

: straw-coloured aspirate and high viscosity

18
Q

What are NICE reccomendations for osteoarthritis>

A

Patient >45 with no (or less than 30 mins) morning stiffness and ‘typical activity related joint pain’ does not need Ix but XR can confirm diagnosis & show severity. (NICE 2014)

19
Q

What are osteophytes?

A

spurs of bone projecting from either end of joint

20
Q

What is Subarticular/subchondral sclerosis?

A

increased bone density along joint line (where bones are in contact)

21
Q

What are subchondral cysts?

A

small, fluid-filled ‘holes’ in bone, along joint line

22
Q

What bony deformities are formed in osteoarthritis?

A

Nodes are formed by bony projection/enlargement (exostosis)

  1. Herberden’s
  2. Bouchard’s
23
Q

What are Herberden’s and Bouchard’s deformties?

A
  • Heberden’s = bony swelling of the DIP joint

* Bouchard’s = same but at PIP

24
Q

What may you find O/E for osteoarthritis?

A
  1. Creptius
  2. Effusion, erythema
  3. Squaring (base of thumb)
  4. H and B

ANKI Rheumatology (14 decks)

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