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Year Two - Musculoskeletal System > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

What is osteoarthritis?

A

It is defined as a condition in which there is progressive degeneration of cartilage within synovial joints

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2
Q

What three joints are most commonly affected by osteoarthritis - in order?

A

Knees

Hips

Hands

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3
Q

What is the pathophysiology cause of osteoarthritis?

A

There is an initial imbalance of cartilage homeostasis, in which there is increased cartilage degradation in relation to chondrocyte repair

This leads to synovitis and structural deformities within the joint

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4
Q

What five risk factors are associated with osteoarthritis?

A

Older Age

Female Gender

Family History

Joint Trauma

Obesity

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5
Q

Are the clincial features of osteoarthritis unilateral or bilateral?

A

Unilateral

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6
Q

What are the five clinical features of osteoarthritis?

A

Joint Pain

Joint Stiffness

Joint Crepitus

Joint Instability

Reduced Joint Movement

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7
Q

Describe the joint stiffness associated with osteoarthritis

A

It tend to worsen after activity

It tends not to be present in the morning or is present in the morning for a period less than 30 minutes

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8
Q

What is joint crepitus?

A

It is defined as an abnormal popping or crackling sound in joints

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9
Q

What are the additional five clinical features of hand osteoarthritis?

A

Bouchard’s Nodes

Heberden’s Nodes

Squaring of Metacarpophalangeal Joints

Squaring of First Carpometacarpal Joints

Reduced Grip Strength

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10
Q

What are Bouchard’s nodes?

A

They are bony enlargements of the proximal interphalangeal joints

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11
Q

What are Herberden’s node?

A

They are bony enlargements of the distal interphalangeal joints

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12
Q

What two investigations are used to diagnose osteoarthritis?

A

Blood Tests

X-Ray Scans

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13
Q

What two blood test results indicate osteoarthritis?

A

Normal CRP Levels

Normal ESR Levels

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14
Q

What are the four features of osteoarthritis on x-ray scans?

A

LOSS

Loss of Joint Space

Osteophytes

Subchondral Sclerosis

Subchondral Cysts

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15
Q

What are the three clinical diagnostic criteria of osteoarthritis?

A

Age > 45 Years Old

Activity Related Joint Pain

No Morning Joint Stiffness or Morning Stiffness < 30 Minutes

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16
Q

What is the first line management option of osteoarthritis?

A

Conservative Management

17
Q

What are the four conservative management options of osteoarthritis?

A

Patient Education

Weight Loss

Exercise Regimes

Physiotherapy

18
Q

What exercise regimen is recommended to manage osteoarthritis?

A

We advise individuals about local muscle strengthening exercises and general aerobic fitness

19
Q

What is the second line management option of osteoarthritis?

A

Pharmacological Management

20
Q

What are the four pharmacological management options of osteoarthritis?

A

Topical NSAIDs +/- Oral Paracetamol

Oral NSAIDs +/- Topical Capsaicin

Oral Opiates

Intraarticular Corticosteroid Injections

21
Q

When are topical NSAIDs +/- oral paracetamol used to manage osteoarthritis?

A

They are the first line pharmacological management option

22
Q

When are oral NSAIDs +/- topical capsaicin used to manage osteoarthritis?

A

They are the second line pharmacological management option

23
Q

Which drug class should be co-prescribed with oral NSAIDs? Why?

A

Proton pump inhibitors (PPIs)

This is in order to provide gastric protection

24
Q

When are oral opiates used to manage osteoarthritis?

A

They are the third line pharmacological management option

25
Q

Name two oral opiates used to manage osteoarthritis

A

Codeine

Morphine

26
Q

When are intraarticular corticosteroid injections used to manage osteoarthritis?

A

They are used to treat acute exacerbations of osteoarthritis, in order to provide temporary reduction in inflammation and symptomatic relief

27
Q

What is a common side effect of intraarticular corticosteroid injections?

A

Steroid Flare

This is when individuals experience a worsening of clinical features in the first few days after administration

28
Q

What is the third line management option of osteoarthritis?

A

Surgical Management

29
Q

What is the surgical management option of osteoarthritis?

A

Joint Arthroplasty

30
Q

What is joint arthroplasty?

A

It involves removal of damaged bone and cartilage and replacement with metal/plastic joint surface in order to restore joint function

31
Q

What are the seven complciations of total hip replacement?

A

Venous Thromboembolism

Intra-Operative Fracture

Surgical Site Infection

Common Peroneal Nerve Injury

Asecptic Loosening

Leg Length Discrepancy

Posterior Hip Dislocation

32
Q

What is the most common reason for total hip replacement revision?

A

Aseptic Loosening

33
Q

What is the clincial feature of aseptic loosening?

A

Hip/Groin Pain

This pain radiates down to the knee

Year Two - Musculoskeletal System (15 decks)

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