Osteoarthritis Flashcards
the breakdown of cartilage in osteoarthritis causes what?
causes bones to rub together and grow spurs (osteophytes)
OA is the most common cause of _____ ______ in adults worldwide d/t pain and altered joint function
chronic disability
what are the 6 areas that OA most commonly develops in?
neck
shoulders
hands
lower back
hips
knees
what are 3 main causes of secondary OA?
genetic joint conditions
trauma
metabolic conditions
what lab is usually low in OA?
leukocytes in joint fluid
what is the prominent leukocyte found in the OA synovium?
macrophages
how is OA characterized?
presence of proinflammatory mediators as well as anti-inflammatory cytokines
what is the pathogenesis of OA?
proinflammatory factors > anti-inflammatory cytokines
when is stiffness most prominent? (2)
morning
after periods of inactivity
node that is on the joint closest to the fingertip (DIP joint)
Heberden’s node
node that is on the middle joint of the finger (PIP joint)
Bouchard’s node
which node may be associated with a digital myxoid (mucous) pseudocyst?
Heberden
what views are recommended for xrays?
weightbearing views
what is the goal of treatment of OA?
slow progression
what is the non-op treatment for OA? (5)
NSAIDs
rehab
weight loss
bracing (knee)
+/- joint injections
what analgesics can be used for non-op treatment? (3)
acetaminophen
oral NSAID
diclofenac topical
what is the goal of physical therapy?
teach patient how to work out stiffness without further damaging joints
why is physical therapy important?
not using joints causes worsening stiffness
what are the 3 types of exercises appropriate for OA? how often should they be done?
ROM; everyday
strengthening; everyday
non-impact; 3x a week
what is directly correlated to progression of knee, ankle, and foot OA?
BMI
OA in which body part inhibits healthy activities, leading to an increased BMI?
knee OA
what treatment can be used to temporarily decrease pain and inflammation to improve function?
steroid injections
how often can steroid injections be used?
3 injections/year
what non-op treatment increases viscoelasticity of synovial fluid and can be repeated q 6 months as needed?
hyaluronic acid injections
in which patients should hyaluronic acid injections be considered?
failed steroid injections
what should patients know when getting a hyaluronic acid injection?
no impact weight bearing activities for 24-48 hrs
what non-op treatment is available (but not FDA approved) to help tissue healing by releasing growth factors?
platelet-rich plasma (PRP)
what is the operative treatment for OA of the knee?
total knee replacement
what can be seen in xray to indicate OA? (4)
joint space narrowing
sclerosis
bone end deformity
osteophytes (bone spurs)
