Osteoarthritis

Question 1

define osteoarthrtis

Answer 1

degenerative disease of the whole joint, where there is a loss of articular cartilage and underlying bone over time

non-inflammatory arthrtis

Question 2

RF for osteoarthritis

Answer 2

• older age
• joint/overuse injuries
• female
• obesity
• anatomical factors: hip dysplasia
• muscle weakness due to other things: CTDs, inactivity

Question 3

is osteoarthritis common?

Answer 3

yes, most common form of arthritis

Question 4

what is primary vs secondary osteoarthritis?

Answer 4

primary: no inciting cause results in OA, more so overtime and degeneration

secondary: there is an underlying condition resulting in OA like endocrine disorders, CTDs, trauma, infectious arthritis, AVN

Question 5

pathophys of osteoarthritis

Answer 5

Progressive loss of articular cartilage and the underlying bone of synovial joints

1. increase of age ➔ decrease synovial fluid
2. wearing down articular cartilage
3. bone on bone friction
4. stimulates bone regrowth ➔ forms osteophytes
5. overall friction and rubbing and may result in capsule swelling ➔ pain

result: decreased joint space, osteophytes, and subchondral cysts/sclerosis

Question 6

s/s of osteoarthritis

Answer 6

most common presenting signs: joint pain, stiffness and loss of ROM/function

Other
- Bouchard nodes (proximal interphalangeal joint)
- Heberden nodes (distal interphalangeal joint)
- morning stiffness (<1h)
- pain worse with activity, gets better with rest
- crepitus
- pain with passive ROM (bc its an actual joint issue)

non-inflammatory arthritis

Question 7

most common joint affected in osteoarthritis

Answer 7

most commonly affects weight bearing joints
like the medial aspect of the knee

Question 8

is osteoarthritis usually symmetrical?

Answer 8

it can be, but often it is asymmetrical

Question 9

how to ix osteoarthritis

Answer 9

radiographic osteoarthrtiis is common

clinical dx

XR would be most clinically indicated

MRI usually not indicated for OS specifically, but could be done to r/o other ddx (AVN, infectious arthritis, fracture)

labs would look normal most likely

Question 10

how to tx osteoarthritis

Answer 10

non-pharma
- PT/rehab (aquatic fitness), wt loss, reduce triggering events, OT for decreasing load bearing devices (canes, braces etc.)

pharma
- NSAIDs - oral or topical (voltaren) ➔ PPI
- intraarticular injections – steroids, HA, or platelet rich plasma

surg - replacement