Osteoarthritis Flashcards
Osteoarthritis (OA) is a disease of the bone and joints of the body that become inflamed and damage the cartilage, and is the most common joint condition worldwide. How many people in the UK have joint pain associated to OA?
1 - 85 people
2 - 8500 people
3 - 850,000 people
4 - 8.5 million people
4 - 8.5 million people
Which of the following is NOT a typical risk factor for developing osteoarthritis?
1 - increasing age
2 - female gender
3 - occupation
4 - muscle strength
5 - obesity
6 - inflammatory joint disease
4 - muscle strength
- muscle weakness is associated
All of the following are risk factors for developing osteoarthritis. Which is often the most common risk factor?
1 - increasing age
2 - female gender
3 - occupation
4 - muscle weakness
5 - obesity
6 - inflammatory joint disease
1 - increasing age
Osteoarthritis is a degenerative disease. Does it worsen with age?
- yes
- 70% of >65 y/o will have it
Organise the following labels describing the general pathology of osteoarthritis?
1 - secondary joint inflammation occurs
2 - continued microtrauma damages chondral surface
3 - articular cartilage lining bones is damaged reducing joint space
4 - formation of new bone begins called osteophytes
1 - articular cartilage lining bones is damaged reducing joint space
2 - formation of new bone begins called osteophytes
3 - secondary joint inflammation occurs
4 - continued microtrauma damages chondral surface
Chondrocytes are the cells within the articular cartilage at the end of bones. These chondrocytes are contained within a gel like structure. What type of collagen is contained within this gel matrix?
1 - type IV
2 - type III
3 - type II
4 - type I
3 - type II
- also contains proteoglycans
- all provide gel and cushion like material
Osteoarthritis is a degenerative disease. Which of the following joints does it NOT commonly affect?
1 - hips
2 - knees
3 - small joints of the hand (DIP, PIP and
4 - Carpometacarpal joints)
5 - proximal interphalangeal (PIP) and metacarpophalangeal (MCP)
- 5 - proximal interphalangeal (PIP) and metacarpophalangeal (MCP)
- RA affects these joints
Which of the following is NOT a typical differential for osteoarthritis?
1 - RA
2 - gout
3 - pseudogout
4 - polymyalgia rheumatica
5 - psoriatic arthritis
6 - septic arthritis
7 - ankylosing spondylitis
7 - ankylosing spondylitis
Which of the cytokines below is NOT typically involved in inflammation of osteoarthritis?
1 - TNF-a
2 - IL-6
3 - IL-4
4 - IL-1
3 - IL-4
What is often the first line imaging in a patient with suspected osteoarthritis?
1 - X-ray
2 - MRI
3 - CT
4 - ultrasound
1 - X-ray
- 2 views at least is required
Osteoarthritis is a degenerative disease. This can cause a number of signs that we can see on an X-ray in an affected joint. Use the labels below to label the affected joint:
- osteophyte (bone spurs)
- sub-chondral sclerosis (thickening of bone)
- joint space narrowing
- sub-chondral cysts (fluid filled cavities in bone)
joint space narrowing
sub-chondral cysts (fluid filled cavities in bone)
osteophyte (bone spurs)
sub-chondral sclerosis (thickening of bone)
Why do we see a narrowing of joint space in a patient with osteoarthritis?
1 - increased articular cartilage formation
2 - increased bone formation
3 - reduced synovial fluid
4 - reduced articular cartilage
4 - reduced articular cartilage
Osteoarthritis is a degenerative disease. This can cause a number of signs that we can see on an X-ray in an affected joint, as we can see in the image below. There are 2 things that can appear on the hands of patients with osteoarthritis, what are they?
1 - ganglion cysts + heberdens nodes
2 - ganglion cysts + bouchard’s nodes
3 - heberdens nodes + warts
4 - heberdens nodes + bouchard’s nodes
4 - heberdens nodes + bouchard’s nodes
- heberdens nodes occurs in DIP joints of hands
- bouchard’s nodes occurs in PIP joints of hands
Osteoarthritis is a degenerative disease. This can cause a number of signs that we can see on an X-ray in an affected joint, as we can see in the image below. There are 2 things that can appear on the hands of patients with osteoarthritis, heberdens nodes + bouchard’s nodes. What is the difference between the 2?
- where they affect in the hand
- heberdens nodes occurs in DIP joints of hands
- bouchard’s nodes occurs in PIP joints of hands
Is osteoarthritis an inflammatory (immune system involvement) or non-inflammatory joint pain?
- non-inflammatory
Is osteoarthritis or RA more likely to cause warm joints?
- RA
Osteoarthritis is a degenerative disease. How long does morning stiffness generally last in patients with osteoarthritis?
1 - >1 hour
2 - no stiffness
3 - >3 hours
4 - <30 minutes
4 - <30 minutes
- helps identify that it is a non-inflammatory disease
Osteoarthritis is a degenerative disease. Does exercise make the symptoms worse or better?
- worse
Osteoarthritis is a degenerative disease. Patients can present with crepitus. What is crepitus?
- crackling feeling when holding a joint
Is inflammation common in osteoarthritis?
- no
- but there are bony enlargements and/or tenderness
Osteoarthritis is a degenerative disease. This can cause a number of signs that we can see on an X-ray in an affected joint, as we can see in the image below. There are 2 things that can appear on the hands of patients with osteoarthritis, heberdens nodes + bouchard’s nodes, which we can distinguish between by which joints they affect. The mnemonic
- High Definition
- Blood Pressure
What do each of the above relate to in heberdens nodes and bouchard’s nodes?
- High Definition = Heberdens and DIP
- Blood Pressure =
Bouchard’s and PIP
- Blood Pressure = Bouchard’s and PIP
Is there a clinical correlation between the radiological changes and the symptoms in osteoarthritis?
Yes
No
- no
- patients can have degenerative changes but no symptoms
What is the most effective way to diagnose osteoarthritis?
- clinical diagnosis based on the patients symptoms
- X-ray and imaging can support the diagnosis
- X-ray and blood samples are vague
Which of the following is NOT a conservative management approach in patients with osteoarthritis?
1 - lifestyle changes
2 - exercise and weight loss
3 - analgesia
4 - surgery
5 - steroid injections
4 - surgery
Osteoarthritis is a degenerative disease. This can cause a number of signs that we can see on an X-ray in an affected joint, as we can see in the image below. There are 2 things that can appear on the hands of patients with osteoarthritis, heberdens and bouchard’s nodes. What are these nodes?
1 - fluid filled nodes
2 - fatty infiltrate nodes
3 - bony growths
4 - cartilage expansion in joints
3 - bony growths
Which of the following is the mnemonic used to identify joint changes on radiography in patients with osteoarthritis?
1 - LOAD
2 - LOSS
3 - LOSE
4 - LEAN
2 - LOSS
L = loss of joint space
O = osteophytes
S = subchondral sclerosis (thickening of the bone)
S = subchondral cyst
There are broadly 3 types of surgery for osteoarthritis. Which of the following descriptions matches osteotomy?
1 - fusion of the joint
2 - realign the joint
3 - partial joint replacement
4 - full joint replacement
2 - realign the joint
- helps redistribute the weight
There are broadly 3 types of surgery for osteoarthritis. Which of the following descriptions matches arthrodesis?
1 - fusion of the joint
2 - realign the joint
3 - partial joint replacement
4 - full joint replacement
1 - fusion of the joint
- fusion of the joint to eliminate painful movement
E.g. Big toe MTPJ, subtalar fusion
There are broadly 3 types of surgery for osteoarthritis. Which of the following descriptions matches arthroplasty?
1 - fusion of the joint
2 - realign the joint
3 - partial joint replacement
4 - full joint replacement
3 - partial joint replacement
4 - full joint replacement
If a patient needs a hip replacement, there are broadly speaking 3 different types. Which of the following is the description for a Hemi-arthroplasty?
1 - femoral head and neck are replaced, acetabulum remains
2 - femoral head, neck and acetabulum are replaced
3 - femoral head and acetabulum are replaced
1 - femoral head and neck are replaced, acetabulum remains
If a patient needs a hip replacement, there are broadly speaking 3 different types. Which of the following is the description for a Total arthroplasty?
1 - femoral head and neck are replaced, acetabulum remains
2 - femoral head, neck and acetabulum are replaced
3 - femoral head and acetabulum are replaced
2 - femoral head, neck and acetabulum are replaced
If a patient needs a hip replacement, there are broadly speaking 3 different types. Which of the following is the description for a resurfacing total arthroplasty?
1 - femoral head and neck are replaced, acetabulum remains
2 - femoral head, neck and acetabulum are replaced
3 - femoral head and acetabulum are replaced
3 - femoral head and acetabulum are replaced
When we look at hip fractures, we need to decide if the fracture is intracapsular or extracapsuluar. What is the bony anatomical landmark that delineates the line between them?
1 - intertrochanteric line
2 - lesser trochanter
3 - gluteal tuberosity
4 - pectineal line
1 - intertrochanteric line
When we look at hip fractures, we need to decide if the fracture is intracapsular or extracapsuluar. The intertrochanteric line determines the anatomical landmarks that determine if it is a intracapsular or extracapsuluar fracture. Why is this important?
1 - identify type of surgery required
2 - identify if patient can be managed conservatively
3 - identify if blood supply is likely to be disrupted
3 - identify if blood supply is likely to be disrupted
- intracapsular fractures are likely to disrupt blood supply to head of femoral bone
- can cause avascular necrosis
Which of the following is NOT an acute general complication of hip and knee surgery?
1 - myocardial infarction
2 - fat embolism
3 - infection
4 - pulmonary embolism
5 - DVT
3 - infection
- generally a long term issue
Which of the following is NOT an acute local complication of hip and knee surgery?
1 - neurovascular injury
2 - PE
3 - dislocation
4 - fracture
5 - infection
6 - bleeding
2 - PE
Which of the following is NOT an long term complication of hip and knee surgery?
1 - Implant failure / Loosening
2 - Metallosis
3 - PE
4 - Dislocation
5 - Failure to achieve desired outcome
3 - PE
- Metallosis = metallic debris builds up in peripheries
