Osteoarthritis

Question 1

Where is osteoarthritis more likely to affect?

Answer 1

• Large, weight bearing joints such as the knee, hip and lumbar spine. Can also affect distal and proximal IPJs

Question 2

Explain the difference of osteoarthritits from other inflammatory diseases?

Answer 2

OA pain is worse with movement and towards the end of the day and morning stiffness is not prolonged (20min)
Pain in inflammatory diseases improves with movement and EMS is prolonged > 30min

Question 3

What are risk factors of osteoarthritis?

Answer 3

Obesity,
Repetitive trauma from occupation or sporting activities,
Hypermobility

Question 4

What are examination features of osteoarthritis?

Answer 4

• Reduced ROM,
• Swelling,
• Crepitus,
• Heberden’s nodes (DIP joint)
• Bouchard’s nodes (PIP joint),
• Squaring of thumbs

Question 5

What are the X-ray features of osteoarthritis?

Answer 5

• Loss of joint space,
• Osteophytes,
• Subchondral cysts,
• Subarticular sclerosis

Question 6

What is the conservative management of osteoarthritis?

Answer 6

• Weight loss and exercise,
• Physiotherapy and occupation therapy

Question 7

What is the pharmacological management of osteoarthritis?

Answer 7

• Analgesia (NSAIDs - topical is first line for knee arthritis)
• Severe cases then use intra-articular steroid injections

Question 8

What is the surgical management of osteoarthritis?

Answer 8

• Arthroplasty (relieves pain but doesn’t improve function)
• Joint fusion or excision

Question 9

What are red flag symptoms for hip pain?

Answer 9

Rest pain, night pain and EMS > 2 hours

Question 10

What is osteoarthritis?

Answer 10

It is mechanical and biological eveents which destabalise the normal process of degredation and synthesis of cartilage chondrocytes, ECM and subcondral bone

Question 11

What are the investigations for suspected osteoarhtirits?

Answer 11

X-ray