Osteoarthritis

Question 1

What is OA

Answer 1

Wear and tear of hyaline cartilage causing progressive cartilage loss and accompanying periarticular change

Question 2

what are factors of primary OA

Answer 2

Genetics
Biomechanical factors like joint injury
>50
Female

Question 3

What is it called when new bone forms at joint margins

Answer 3

Osteophytes

Question 4

What are the 2 types of OA

Answer 4

Localised
Generalised

Question 5

What is a good indication of generalised OA

Answer 5

Heberden’s nodes - at distal interphalangeal joints (ONLY IN RA)

Question 6

Where are Bouchard’s nodes found

Answer 6

proximal to interphalangeal joints, less common also seen in RA

Question 7

what joints are most commonly affected by OA

Answer 7

Knees
Hands
Hips

Question 8

OA symptoms

Answer 8

Joint stiffness less than 30 mins
Pain - worsens on joint usage
Pain at night
Poor grip of thumb
Inactivity gelling - stiff joints after activity

Question 9

Where can pain be felt in hip OA

Answer 9

Groin and radiating to the knee/ lower back

Question 10

Clinical OA signs

Answer 10

Joint line tenderness
Crepitus (crunching sound)
Joint effusion
Bony swellings
Deformity

Question 11

Best radiography for diagnosing OA & what does it show

Answer 11

X-ray
- Loss of joint space
- Marginal Osteophytes
- Subchondral cysts
- Subchondral sclerosis

Question 12

Management non-pharmacological

Answer 12

• Lifestyle management (lose weight, exercise)
• Physiotherapy
• Education

Question 13

Management Pharmacological

Answer 13

• Analgesia (paracetamol, NSAID’s)
• Local intra-articular steroid injections for flare-up (up to 3 a year)

Question 14

Management Surgical

Answer 14

Joint replacement
Arthroscopic surgery to remove loose bodies