Osteoarthritis Flashcards
Risk factors of osteoarthritis ?
positive family history
Women
Previous trauma of a joint
Obesity
Hypermobility
Which occupation has increased risk of osteoarthritis ?
cotton workers and farmers are more susceptible to hand OA
What reduces the risk of OA ?
Osteoporosis
presence of hand OA increases the risk of ?
future hip and knee OA
What joints are affected by osteoarthritis ?
Usually bilateral:
Usually one joint at a time is affected over a period of several years.
The carpometacarpal joints (CMCs), distal interphalangeal joints (DIPJs)
Characteristic of joint pain in osteoarthritis ?
Episodic joint pain
Joint pain provoked by movement and relived by rest
difficult to open jars in the evening than in the morning.
Other symptoms of osteoarthritis ?
Stiffness:
worse after long periods of inactivity e.g. waking up in the morning
stiffness lasts only a few minutes !!compared to the morning joint stiffness seen in rheumatoid arthritis.
Painless nodes (bony swellings)
Heberden’s nodes at the DIP joints
Bouchard’s Nodes at the PIP (proximal interphalangeal) joints
Squaring of the thumbs: Deformity of the carpometacarpal joint of the thumb resulting in fixed adduction of the thumb.
If there is severe involvement of the DIPJs, there may be reduced?
Grip strength
Functionally patients do not usually have any problems
What are typical finding of osteoarthritis in Xray ?
X-ray: radiologically there are osteophytes and joint space narrowing.
Often signs may be visible on X-ray, before symptoms develop!
Which develops first in osteoarthritis radiological or clinical signs ?
Radiological !
Mx of osteoarthritis
first line - paracetamol and topical NSAIDS such as topical ibuprofen
Second line Mx of osteoarthritis ?
oral NSAIDs/COX-2 inhibitors,
opioids,
capsaicin cream
and intra-articular corticosteroids
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