osteoarthritis Flashcards
what is the primary aetiology of osteoarthritis? (2)
- age
- gender
when does osteoarthritis incidence increase?
- increases after menopause
how does culture act as a primary factor in osteoarthritis?
- cultural norms
- genes
what are the six secondary aetiology factors of osteoarthritis?
- obesity
- bone density
- joint injury
- development disorders
- femoral acetabular impingement
- lifestyle
does obesity always act as secondary factor to osteoarthritis?
- knee yes
- hip not proven
how does bone density link to osteoarthritis?
- people with known osteoporosis have lower incidence of hip OA
what is one of the strongest risk factors for developing OA?
- joint injury
what development disorders act as secondary factors of OA? (3)
- perthes disease
- development dysplasia
- slipped capital femoral epiphysis
how does lifestyle contribute to osteoarthritis?
- repetitive excessive loading thought to increase OA but regular recreational activities does not
are X-rays used in diagnosis of osteoarthritis? what does this include?
- MRI and CT scans
- can detect OA but rarely used
what are the main four physical symptoms of osteoarthritis?
- pain and stiffness
- characteristic morning stiffness
- restricted ROM
- decreased functional ability
what are the symptoms described as?
- generally getting worse
what is the onset of symptoms in people with OA?
- idiographic onset
what do osteoarthritic individuals often experience on a day to day basis?
- good and bad days
what may happen to leg length due to osteoarthritis?
- leg length discrepancy due to loss of joint space
what is osteoarthritis characterised by?
- characterised by flare- up/ remissions so symptoms will vary in severity dependably
what are the 6 main signs of osteoarthritis?
- age
- loss of ROM
- swollen joints
- joint deformity
- decreased functional ability
- bony lumps and boggy swelling
what does ACR stand for?
- American college of rheumatology
what is the ACR algorithm?
- clinical classification criteria for osteoarthritis of the hip
- without an x-ray
what are the clinical ACR guidelines for hip OA?
- pain and internal rotation <15 and flexion of hip <115 or internal rotation >15, pain at internal rotation, stiffness <60 min and age > 50 years
why are x-rays designated as gold standard by WHO?
+ cheap
+ instant
+ easily intepreted
what are the three main x-ray based grading systems?
- Kellgren- Lawrence system
- croft modification of the kellgren- Lawrence system
- croft minimal joint space grading system
what is the most widely used X-ray grading scale of OA?
- Kellgren- Lawrence system
how many grades are there in the Kellgren- Lawrence system?
- grade 0 to grade 4
what is grade 0 of the Kellgren- Lawrence system
- no osteoarthritis
what is grade 1 of the Kellgren- Lawrence system?
- doubtful narrowing of joint space and possible osteophytic lipping
what is grade 2 of the Kellgren- Lawrence system?
- minimal definite osteophytes, definitie minimal/ little narrowing of joint space
what is grade 3 of the Kellgren- Lawrence system?
- moderate multiple osteophutes, definite narrowing of joints space narrowing of at least 50%
- some sclerosis and possibly deformity of bone contour
what is grade 4 of the Kellgren- Lawrence system?
- large osteophytes
- severe loss of joint space
- severe sclerosis
- definite deformity of bone contour
how many grades are there in the croft radiographic grading scale?
- grade 0 to grade 5
what is grade 0 in croft radiographic grading scale?
- no change
what is grade 1 in croft radiographic grading scale?
- definite osteophytes only
what is grade 2 in croft radiographic grading scale?
- joint space narrowing only (defined as an minimal joint space of 2.5mm)
what is grade 3 in croft radiographic grading scale?
presence of two of the following:
- joint space narrowing
- osteophytosis
- subchondral sclerosis (of >5mm)
- cyst formation
what is grade 4 in croft radiographic grading scale?
presence of three of the following:
- joint space narrowing
- osteophytosis
- subchondral sclerosis (of >5mm)
- cyst formation
what is grade 5 in croft radiographic grading scale?
- same as grade 4
- with deformity of the femoral head or total hip replacement due to OA
how many grades in the croft minimal joint space grading scale?
- grade 0 to grade 2
what is grade 0 in croft minimal joint space grading scale?
- minimum joint space > 2.5mm
what is grade 1 in croft minimal joint space grading scale?
- minimum joint space of >1.5mm < 2.5mm
what is grade 2 in croft minimal joint space grading scale?
- minimum joint space <1.5mm
what positive correlation does the Kellgren and Lawrence Scale and the Croft minimum have?
- positive correlation with the clinical symptoms of pain and disability
what are the three treatment options of individual with osteoarthritis?
- conservative
- pharmacological
- surgery
what conservative treatment has strong evidence for OA? (3)
- exercise
- education
- self management
what devices can be used for conservative treatment for OA?
- assistive devices
- walking aids
what advice should be given in conservative treatment of OA?
- advice on weight loss
what other therapies/ techniques can be used in combination with exercise? (4)
- manual therapy
- electrotherapy
- thermotherapy
- acupuncture
what are the 4 guidance organisations acronyms that provide best practice evidence?
- OARSI
- ACR
- EULAR
- NICE
what is OARSI?
- osteoarthritis research society international
what is ACR?
- American college of rheumatology
what is EULAR?
- European league against rheumatism
what is NICE?
- national institute for health and care excellence
when should surgery be offered?
- only offered if conservative treatment is not effective
what should you explain when educating patients with osteoarthrosis?
