Osteoarthritis

Question 1

OA (3)

Answer 1

most common form of arthritis and is primarily a degenerative disorder.

Over time the normal structure of every joint is subject to wear and deterioration.

Alongside OA there may also be a considerable amount of associated inflammation, which can lead to periodic flaring of the OA.

Question 2

primary cause of OA (7)

Answer 2

no definite causative factor is found (known as “primary OA”)

wear and repair of cartilage within joints.

aging

female sex

obesity

environmental factors

hobbies and type of work

Question 3

secondary OA causes (10)

Answer 3

Congenital dislocation of the hip
Perthes
SUFE
Previous intra‐articular fracture
Extra‐articular fracture with malunion
Osteochondral / hyaline cartilage injury
Crystal arthropathy
Inflammatory arthritis (can give rise to mixed pattern arthritis)
Meniscal tears
Genu Varum or Valgum

Question 4

Interpretation of a X‐ray in OA (4)

Answer 4

L – loss of joint space

O – osteophytes

S – sclerosis

S – subchondral cysts

Question 5

difficulty of imaging (4)

Answer 5

matching investigation findings with symptoms in older ptaients

some patients with substantial X‐ray changes of OA have minimal symptoms

some patients who are substantially symptomatic can have only mild disease on imaging.

treat the patient and their symptoms and not the images.

Question 6

Management (4)

Answer 6

pain control. Simple analgesia and mild opiates may be helpful.

Physiotherapy is useful in strengthening surrounding structures.

Weight loss and exercise are also important.

In some situations surgery may be an option e.g. hip and knee replacement, but this depends on the joint affected.