osteoarthritis Flashcards
what is the primary site of damage in osteoarthritis
articular cartilage
most common risk factors for OA
female, age, obesity, injury to or overuse of a particular joint, family history, muscle weakness
most preventable risk factor OA
obesity– weight loss of 5 kg decreases risk by 50%
what occurs upon damage to cartilage
increased chondrocyte activity leading to cartilage swelling–> increased water content and cartilage thickening–> MMP secretion–> proteoglycan breakdown–> increased cartilage permeability and destruction–> bony remodeling
typical age at presentation
> 50
how long does morning stiffness last OA
<30 minutes
the pain in OA is associated with ___
motion
signs of OA
crepitus
indicators of OA
osteophytes, bouchard nodes, heberden nodes, joint space narrowing
what are the primary joints affected in OA
DIP, CMC
joint characteristics in OA vs RA
OA hard and bony
RA soft and spongey
lab findings in OA?
RF, ACPA
NORMAL ESR AND CRP
strongly recommend in hand OA
oral NSAIDs
conditionally recommend in hand OA
topical NSAIDs (pref over PO for those >75 yo)
intraarticular steroids
APAP
duloxetine
tramadol
chondroitin
strongly recommend against in all OA
bisphosphonates
glucosamine
HCQ
MTX
biologics
conditionally recommend against in all OA
non-tramadol opioids
colchicine
fish oil
vitamin D
strongly recommend in knee OA
topical NSAIDs
oral NSAIDs
intraarticular steroids
conditionally recommend in knee OA
topical capsaicin
APAP
duloxetine
tramadol
strongly recommend in hip OA
oral NSAIDs
intraarticular steroids
conditionally recommend in Hip OA
APAP
duloxetine
tramadol
APAP mech
inhibition of central prostaglandin synthesis
APAP dosing
325-650 mg q4-6h
or 1000 mg 3-4x/day
APAP max
4 g daily or 2 g for alcoholic cirrhosis
APAP warnings
liver disease