Osteoarthritis

Question 1

OA description

Answer 1

Degenerative arthritis

Characterized by cartilage degeneration

Subsequent bony changes

Sometimes Inflammation

Question 2

Bony changes

Answer 2

Osteophytes - bone spurs

Subchondral sclerosis

Bone cysts - fluid filled hole that develops inside a bone

Joint space narrowing

ALL contribute to OA pain

Question 3

Subchondral Sclerosis

Answer 3

Increased bone density or thickening in the subchondral layer (Bone layer directly under cartilage)

Occurs with progressive OA

Shows up on x rays

Question 4

General Stats

Answer 4

Occurs equally in M and F

Over age 40, 80% have X-ray evidence of OA

2-3% of adults have symptomatic OA

Question 5

Symptoms

Answer 5

Joint pain, worse with activity, better with rest

Morning stiffness < 30 minutes

Limited ROM

Crepitus

Instability

Joint enlargement

Question 6

Commonly affected joints

Answer 6

Primarily Hips, Knees, and Hands

DIP

PIP

CMC

AC

Hip

Knee

1st MTP

Spine

Question 7

Primary or Secondary

Answer 7

Primary OA
- associated with aging, “wear and tear”

Secondary OA-
- develops early life, typically 10 or more years after a specific cause (injury, obesity, etc.)

Question 8

Risk Factors

Answer 8

Obesity

Heavy physical labour

Heredity

Age

Previous joint trauma

Abnormal joint mechanics

Question 9

Secondary Causes

Answer 9

Trauma

CPPD disease (Chondrocalcinosis, calcium crystal deposition disease)

Congenital hip dysplasia

Metabolic disorders

Endorcrine disorders

Intrinsic bone disease

Ostencrosis

Neuropathic disorders

Question 10

Treatment

Answer 10

Analgesics

NSAIDs

Weight control

Strengthening exercises, ROM

Intra-articular injection: steroids, visco-supplementation

Surgery: joint debridement, osteotomy, total joint replacement