Osteoarthritis Flashcards
What is osteoarthritis?
- Asymmetrical degenerative synovial joint disease
2. Cartilage destruction exceeds repair, causing pain & instability
What is common epid of osteoarthritis?
Women
50-70
What are RF for osteoarthritis?
- Female
- Over 50
- FHx of OA
- Demanding sport or occupation
- Obesity
What are the most common joints affected in OA?
- knee
- hip
- hands
- lumbar
- cervical spine
What are classic symptoms of OA?
- Joint pain
- Morning stiffness: around 15 ins
- Stiffness worse with activity
- Limited range of motion
- Bony deformities
What are possible DDx for OA?
- Bursitits
- Gout
- Pseudogout
- RA
- Psoriatic arthritis
What investigations are used for OA?
- X ray
- CRP: normal
- ESR: normal
What is seen on x ray for osteoarthritis?
- Loss of joint space
- Osteophytes
- Subarticular sclerosis
- . Subchondral cysts
What is management for osteoarthritis?
- Topical analgesia e.g. capsaicin topical
- Intra-articular corticosteroid injection
- Paracetamol
- NSAIDs
- Opiod
- Surgery (joint replacement)
- Exercise and weight loss
What are possible complications for OA?
- Functional decline and inability to perform activities of daily living
- Spinal stenosis in cervical and lumbar OA
- NSAID-related GI bleeding
- Effusion
- NSAID related renal dysfunction
What is primary osteoarthritis?
Localised (hands, knee, hip or foot) or generalised (hands and another joint)
What is the cause of primary osteoarthirtis?
wear and tear of normal joint
What is the usual epid of primary osteoarthritis?
- Female
- Obese
- Older
- Post menopausal
- Occupation: gardener, hairdresser
What is the usual causes of secondary osteoarthritis?
- Inflammatory: RH or Septic arthritis
- Congenital: DDH
- Metabolic/Endo – wilson’s or acromegaly, haemchromatosis
- Trauma
What is the cause of
secondary osteoarthritis?
altered joint architecture/stability acquires further damage
Why does osteoarthritis occur?
imbalance of cartilage matrix synthesis & degradation (increased catabolism or reduced formation)
What is seen on joint aspiration for osetoarthritis?
: straw-coloured aspirate and high viscosity
What are NICE reccomendations for osteoarthritis>
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)
What are osteophytes?
spurs of bone projecting from either end of joint
What is Subarticular/subchondral sclerosis?
increased bone density along joint line (where bones are in contact)
What are subchondral cysts?
small, fluid-filled ‘holes’ in bone, along joint line
What bony deformities are formed in osteoarthritis?
Nodes are formed by bony projection/enlargement (exostosis)
- Herberden’s
- Bouchard’s
What are Herberden’s and Bouchard’s deformties?
- Heberden’s = bony swelling of the DIP joint
* Bouchard’s = same but at PIP
What may you find O/E for osteoarthritis?
- Creptius
- Effusion, erythema
- Squaring (base of thumb)
- H and B
