osteoarthritis Flashcards
osteoarthritis is a —- condition resulting from loss of — in – spaces and development of —
it involves:
the whole joint, including cartilage degradation, bone remodeling, osteophyte formation (bony spurs), and synovial inflammation, leading to pain, stiffness, swelling, and loss of normal joint function
- chronic degenrative
- loss of cartlige
- joint spaces
- bondy spurs
true or false:
1-OA is the most common form of arthritis, affecting an estimated 302 million people worldwide.
2-Leading cause of disability among older adults.
3-The knees, hips, and hands are the commonly affected joints.
all true
1-OA develops due to:
- imbalance in tissue — and — leading to injury exceeds the ability to repair for example:
-Abnormal loading of normal tissues (obesity)
-Ability to repair cartilage declines with age
2- risk factors for OA:
tissue injury and repair
risk factors: ( make sure to know the first 2 )
Increasing age
Obesity
Repetitive use / occupational factors
Joint shape
Women increased knee and hand OA
Trauma / injury
Reduced muscle strength and bulk
Hereditary
Haemachromatosis
Prior septic arthritis
Inflammatory arthritis (eg: rheumatoid arthritis)
obesity risk:
- BMI of — increased risk of knee OA ( inhanes )
- obesity = — increased risk of OA ( framingham study )
- weight loss of – reduces risk ( framingham )
- 30-45 4x
- 40%
- 5kg
symptoms in OA:
patterns of OA:
1-Pain and stiffness
2-Worse with prolonged use
3-Stiffness after immobility
4-Poor correlation with radiographs (x-rays)
5-Multiple factors influence pain including sleep, emotional, stress.
- patterns:
- hands and feet
- spine
- large weight bearing joints- knee and hip
- generalised
diagnosis of OA is mostly —
1- often — and — is enough by seeing the typical patterns of symptoms and joints involved
2- — test normal : mostly done to outrun forms of arthritis as —
3- — abnormal in advanced disease which may show joint space narrowing osteophytes and sclerosis
- clinical
- history and exam
- blood tests
- rheumatoid arthritis
- x rays
management of OA:
1- primary prevetnion by manaintaing of —-
2- acute managemt by —-
3- chronic management by —
1- normal BMI since obesity is a major contributor to OA as it increases the pressure in joints
2- pharmacological approach - pain control
3- chronic management by:
-Multidisciplinary approach (physiotherapy and occupational therapy input)
-Patient education – weight loss and self management
-Surgical approach – total joint replacement may be considered
treatment goals of OA:
- pain control , maintain and restore function , and delay progression if possible
pain control of OA:
1- — should be tried first and many will respond
2- — should be tried next many but not all patients will respond better
3- mild opiates as —
4- start w the — and use as need for — and — only
- paracetamol
- NSAIDS as ibuprofen
- codeine
- simplest
- symptoms and management
- NSAIDS are: —– as —–
- are — and —
- may cause —–
- can aggravate —-
- non-steroidal anti-inflammatory drugs as ibuprofen naproxen ad diclofenac
- anti inflammatory and analgesic
- gastric and GI bleeding
- renal impairment
true or false:
-No proven disease modifying agents for OA – all drugs are for symptom management
answer:
intra articular corticosteriod injection gives – but — relief will reduce – and improves —
- true
- effective
- short term relief
- reduce pain
- improve range of mobility as a result
—– improves symtoms and potentially slows down progression of disease
- wight loss of – associated w clinical and mechanistic outcomes
- beenfits continue to increase w —– , —
- any —- will improve functional status and they key is — compliance after starting
- weight loss
- more than 5%
- 5-10% , 10-20%
- aerobic exercise
- maintaing
—- excersise recommended to maintain mobility and range of movement
—- Can improve function with education and, and joint protection with adaptive equipment / splinting
—– strongly recommended for patients with knee OA causing sufficiently large impact on mobility or joint stability
low weighbearing ( in phsiotherpay )
occupational therapy
- knee braces
knee and hip replacement are — surgery and only considered once all other options have been exhausted
- the success rate is — and — satisfaction for hips and slightly – for knees
- its excellent procedure for —-
- patient must be prepared for some hard work after lol
- major
- high
- more than 90%
- less
- relief of pain
