Osteoarthritis

Question 1

Definition

Answer 1

Osteoarthritis is defined as a disorder of synovial joints which occurs when damage triggers repair processes leading to structural changes within a joint.

Question 2

Risk Factors - 6

Answer 2

Genetic
Age
Females
Obesity
Low bone density
Occupational/Exercise stress

Question 3

Prevalence

Answer 3

Affects 10% men and 18% women over 60 years old

Question 4

Presentation - 5

Answer 4

Pain after movement of joint
NO MORNING STIFFNESS
Bony swellings
Crepitus
Reduced range of movement

Question 5

Pathophysiology of OA

Answer 5

Damage to articular cartilage leads to increased production of fibrous cartilage to replace it. The fibrous cartilage then erodes easily down to bone.

Question 6

Investigations

Answer 6

Diagnosis done by examination, history, if alternative conditions have been ruled out and patient is aged 45yrs or more
X-ray - LOSS
loss of joint space
osteophytes
subcondral cysts
subcondral sclerosis

Question 7

Management (7)

Answer 7

• provide information on sources of advice like versus Arthritis.com
• Weight loss
  -Physiotherapy
  -Psychological support
  -oral NSAIDs or topical NSAIDs (offer with a PPI if they have GI issues). Paracetamol and opioids only recommended after NSAIDs not tolerated
• Cortisol injections
• Joint replacement surgery

Question 8

Complications - 5

Answer 8

Joint Deformity
Depression
Occupational impact - cannot work
Falls
Chronic pain

Question 9

Differentials - 4

Answer 9

Inflammatory arthritis - RA, psoriasis arthritis
Septic joint
bone fractire
malignancy