Osteoarthritis Flashcards

1
Q

What is osteoarthritis?

A

“Wear and tear” of joints - an imbalance between damage and repair of cartilage causing inflammation of joints

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2
Q

What are the four definitive features of OA that can be seen on Xray?

A

L – loss of joint space
O – osteophytes
S – sclerosis
S – subchondral cysts

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3
Q

What are osteophytes and how are they formed in OA?

A

Osteophytes are bony projections that form along joint margins
Formation occurs when broken cartilage is repaired incorrectly

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4
Q

What are some of the predisposing factors that contribute to development of OA?

A
Obesity
Mechanical injuries
High impact sports
Inflammatory arthritis
Female
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5
Q

What are the sites most commonly affected by OA?

A

Hands, knees, hips

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6
Q

Which joints in the hands tend to be affected by OA?

A

DIP, PIP and 1st CMC joints

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7
Q

What are baker’s cysts?

A

Swelling and fluid collection in the back of the knee

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8
Q

What is the clinical presentation of OA?

A

Pain which is worse on activity and relieved by rest, stiffness

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9
Q

Where might pain in the hip caused by OA radiate to?

A

Groin

Knee

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10
Q

Where might pain in the hip be referred from?

A

Lower back

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11
Q

How might spinal sclerosis in OA present and why does this happen?

A

Pain in hips and upper thighs in a pattern similar to intermittent claudication
Due to nerve impingement

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12
Q

What are Heberden’s nodes?

A

Hard or bony swellings that can develop in the distal interphalangeal joints in OA

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13
Q

What would be found in a joint affected by OA on examination?

A
Joint feels hard/bony and cool
Joint tenderness
Joint effusion
Crepitus
Bony enlargements due to osteophytes
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14
Q

What is the pathogenesis of OA?

A

There is loss of the matrix formed by chondrocytes in the cartilage, and release of cytokines (IL1, TNF) from the chondrocytes instead

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15
Q

What causes spinal stenosis?

A

Osteophyte formation on the lumbar spine encroaching on the spinal canal

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16
Q

What are some of the non-pharmacological treatments of OA?

A

Explanation - not because of overuse
Physiotherapy- muscle strengthening, proprioceptive
‘Common sense measures’ - weight loss exercise, trainers, walking stick

17
Q

What are some of the pharmacological treatments of OA?

A

Analgesia – paracetamol, compound analgesics, topical anagesia
NSAIDs - may give additional symptomatic relief, consider risk/benefit ratio
Pain modulators – tricyclics eg. amitriptyline, anti-convulsants eg. gabapentin