Osteoarthritis Flashcards
What are the main features of OA? (7)
Occurs in older age
Due to cartilage wear/tear.
No systemic involvement
Slow onset
Joint aches but have minimal swelling and won’t feel hot to touch.
Morning stiffness < 30 mins.
Affects weight-bearing joints e.g. lower spine, knees. Asymmetrical.
What are the main features of RA? (7)
Occurs at any age.
An autoimmune, inflammatory process.
Can have systemic effects including dry mouth, eyes, skin involvement, fatigue etc.
Onset generally rapid over weeks or months.
Painful and hot to touch joints.
Morning stiffness > 30 mins
Affects joints symmetrically and usually affects hands, wrists and feet.
What are the px expectations of OA + RA? (4)
No cure for OA only symptomatic relief.
Summarise P’s role on OA management. (7)
Recognise presentation.
Px education on OA management.
Signposting to appropriate support and advice.
Meds review
Advice to other HCPs regarding optimal tx e.g. analgesia choice, regular paracetamol, interactions, renal function.
Lifestyle advice
Surgery
Outline the management of OA. (4)
Managed in primary care.
Key presentation: pain when using joints and restricted function.
NICE: OA can diagnosed clinically without investigations if > 45 yrs, actively relating joint pain and no morning joint related stiffness/< 30 minutes.
Other investigations can be offered if other causes of joint pain suspected.
What does OA look like under a X-ray? (1)
Loss of joint space (OA)
What are the tx aims of OA/RA? (4)
Reduce pain/stiffness
Maintains/improve functional capacity including ability to work.
Prevention of progression of joint damage
Improve quality of life.
What analgesics are used in OA? (4)
Don’t routinely offer paracetamol or weak opioids unless they are only used infrequently for short-term pain relief and all other drug tx are c/i/not tolerated or ineffective.
Topical/Oral NSAIDs
Adjunct e.g. capsaicin, intra-articulate steroids.
What are the 3 main risks of NSAIDs use? (3)
CV/GI/Renal risk
Low dose ibuprofen/naproxen used.
Topical vs oral
What needs to be considered when px undergoes surgery in OA? (2)
