Osteoarthritis

Question 1

What are 7predisposing factors for OA ?

Answer 1

1.Previous trauma.
2. SUFE
3. Congenital hip dislocation.
4. Perthes.
5. Osteonecrosis
6. Paget’s.
7. infection

Question 2

Where is OA usually seen ?

Answer 2

ANY SYNOVIAL JOINT
Typically seen in large weight bearing joints (hips, knees and axial skeleton)
Active joints

Question 3

Is OA typically seen in active joints - give examples ?

Answer 3

Yes
DIPJ
PIPJ
CMCJ

Question 4

what is Primary OA ?

Answer 4

Idiopathic hereditary degenerative change.

Question 5

What is Secondary OA?

Answer 5

Degenerative changes that are secondary to trauma. Commonly in knees, hips and spine.

Question 6

List some causes for Secondary OA ?

Answer 6

Trauma
Inflammatory conditions such as RA/ Gout
Obesity ( Causing increased force on that joint)

Question 7

Is joint change in OA symmetrical ?

Answer 7

No asymmetrical.

Question 8

What are the radiographic appearances in OA ?

Answer 8

Loss of joint space (Asymmetrical)
Osteophyte formation ( Bony lumps/ spurs) - Bodies response to increased pressure on the joint.
Subchondral Sclerosis Increase in bone density below the articulating surface.
Subchondral Cysts - Also known as GEODES.

Question 9

what do Subchondral cysts look like and what causes them ?

Answer 9

Focal rounded peri articular lucencies.

They are caused by increased pressure at the joint forcing synovial fluid to herniate into the subchondral bone.

Question 10

Describe the Kilgren- Lawrence classification system to describe OA ? (Grades 0-4)

Answer 10

0 Normal
1 Early/minor - Doubtful joint space narrowing with possible osteophytosis.
2 Mild - Minimal joint space narrowing, definite small osteophyte formation.
3 Moderate - Definite joint space narrowing with multiple moderately sized osteophytes.
4 Severe - Marked joint space narrowing, Multiple or large osteophytes, Marked sclerosis and definite bone deformity.

Question 11

Where is the distribution of Osteoarthritis in the hands and wrist ?

Answer 11

This will be distal interphalangeal joints.

Question 12

What type of patient usually presents with primary OA ?

Answer 12

Middle aged females.

Question 13

Where is primary OA predominantly seen ?

Answer 13

Hands.

Question 14

What is the distribution of Primary Osteoarthritis?

Answer 14

Distal interphalangeal joints, proximal interphalangeal joints and base of the thumb. It is bilateral and symetrical.

Question 15

There are a few joints that exhibit erosions with Osteoarthritis, What are these ? -(Clue- letter joints)

Answer 15

1.TMJ
2.ACJ
3.SIJ
4. symphysis pubis.

Question 16

What other arthropathies can cause GEODES ?

Answer 16

1) Rheumatoid arthritis.
2) Degenerative joint disease.
3) Calcium phosphate dihydrate crystal deposition.
4) Avascular necrosis.