Osteoarthritis

Question 1

What is Arthritis?

Answer 1

Inflammation of the joints

Question 2

What is Osteoarthritis?

Answer 2

Causes joints to become painful and stiff

A clinical syndrome of joint pain
accompanied by varying degrees of functional limitation and reduced quality of life

Disorder of the joints
 Articular cartilage loss
 Accompanying periarticular bone response

Can affect any joint

Weight bearing and non-weight bearing joints

Question 3

What is the most common from of Arthritis?

Answer 3

Osteoarthritis

Question 4

Describe the Epidemiology of Osteoarthritis in the population?

Answer 4

~8.75million people in the UK4 aged 45yr+
 Prevalence increases with age
 More common in women than men5
 Knee is most common site

18.2% of people aged over 45 years in England have Osteoarthritis of the KNEE.

10.9% of people aged over 45 years in England have Osteoarthritis of the HIP.

Question 5

What are the Co-morbidities of Osteoarthritis and its effect on the QoL?

Answer 5

Co-morbidities
 Cardiovascular disease
 Depression

Quality of Life
 Pain
 Work

Question 6

Detail the pathological changes in
Osteoarthritis?

Answer 6

 Whole joint is involved

 Rate of damage exceeds rate of repair

 Joint fails to dissipate ‘load’ effectively

 Leads to cycle of degeneration

 Exposes bone to more load
 more damage

 Further loss of cartilage and growth of osteophytes

 Narrowing of joint space

 Results in synovitis and effusion

Question 7

Describe the risk factors and causes of
osteoarthritis?

Answer 7

 Primary – idiopathic

 Secondary – specific cause
i.e. previous injury to joint, congenital abnormality or inflammatory arthritis

Question 8

What are the Risk factors of Osteoarthritis?

Answer 8

Risk factors:
 Age (45+)
 Gender (female)
 Obesity (BMI >25)
 Occupation (physically demanding)

 Genetics
 Estimated heritability of 40-65% depending on joint site

Question 9

Describe how Osteoarthritis is diagnosed?

Answer 9

Signs/Symptoms:

 Activity related joint pain
 Morning stiffness lasts no longer than 30 minutes
 Muscle wasting
 Hand/fingers often presents as ‘nodes’

Diagnosed clinically without investigations

 Activity related joint pain AND
 Morning stiffness lasts no longer than 30 minutes
(OR no morning stiffness) AND
 Over 45 years

X-rays and blood tests may be help to aid diagnosis

Question 10

Discuss the Pharmacological treatment options in Osteoarthritis?

Answer 10

Pharmacological treatments mostly
involves pain relief:

 Topical NSAIDs or Topical capsaicin
 Paracetamol
 Oral NSAIDs (+PPI)
 Opioids
 Intra-articular corticosteroids

Others…
 Surgery

Question 11

Discuss the Non-Pharmacological treatment options in Osteoarthritis?

Answer 11

Holistic approach

Lifestyle changes
 Weight loss
 Exercise: CORE
 Physical aids

Question 12

What is the summary for Osteoarthritis in terms of patient care?

Answer 12

 No pharmacological treatments to help prevent or cure

 Offer moderate symptomatic relief

 Lifestyle change is key in management
Exercise should be part of daily routine

 Limited role medication can play must be explained to patient