Osteoarthritis Flashcards
What is osteoarthritis?
‘wear and tear’ in the joints
What joints does OA occur in?
Synovial joints
Which joints are commonly affected?
Hips
Knees
Sacro-iliac
DIPs
CMCs
Wrist
Cervical spine (spondylosis)
Is OA inflammatory or mechanical?
Mechanical
What are some risk factors for OA?
Obesity
Age
Occupation e.g. farmer, football player
Trauma
Female
FH
What is the pathogenesis of OA?
Tear- joint microtrauma
Flare- inflammation and pain
Repair- scar tissue
What are the features of OA?
Pain worse on movement, better on rest
Stiffness <30 minutes
Hard, bony swelling
What are some general signs of OA?
Bulky, bony enlargement of joint
Restricted range of motion
Crepitus on movement
Effusions (fluid) around joint
What are some hand signs of OA?
Heberden’s nodes- DIP joints
Bouchard’s nodes- PIP joint
Squaring at thumb CMC joint
Weak grip
Reduced ROM
Why is the thumb prone to wear?
CMC joint is a saddle joint used lots for everyday movements
What is the diagnostic criteria for OA?
> 45
Typical pain associated with activity
No morning stiffness or <30 minutes stiffness
What 4 key changes are seen on X ray?
LOSS:
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts
What is an osteophyte?
Bone spur- tiny pointed outgrowth of bone at a joint
What is subarticular sclerosis?
Thickening of the bone under the cartilage in joints
What is a subchondral cysts?
Fluid filled sac that forms in the bone beneath the cartilage of a joint
What is the management of OA?
- Holistic approach
- Core treatment
- Non pharmacological
- Pharmacological
- Surgery
What is the core treatment?
Patient information
Weight loss
Exercise
What are the non pharmacological treatments?
Physiotherapy
Occupational therapy
Thermotherapy
Electrotherapy
Splints
What are the pharmacological treatments?
Oral paracetamol
Topical NSAIDs
Oral NSAIDs and omeprazole (PPI)
Opiates- codeine, morphine
Intraarticular steroid injections
What is the surgical treatment?
Joint replacement
