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Movement > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

outline the managment stages of OA

A

analgesia
lifestyle changes
surgery

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2
Q

what is passive insufficiency

A

inability of muscle to lengthen adequate for movement

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3
Q

tension injuries result in

A

avulsion fractures

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4
Q

what are Heberden’s nodes

A

bony osteophytes on the DIP joint

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5
Q

what are the risk factors for OA

A 
injury
congenital malformation
hypermobility
obesity
family history
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6
Q

compression injuries lead to

A

vertebral fractures (esp in osteoporosis)

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7
Q

oral analgesics used in the treatment of OA

A

regular paracetamol
NSAIDs (with PPI, cardiac effects and renal failure in the elderly)
opioids

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8
Q

list the radiographic signs of OA

A

joint space narrowing
osteophyte formation
subchondral bone sclerosis
formation of subchondral cysts

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9
Q

list the 3 S’s of muscle action

A

swing - pivot at joint
shunt - holds joint surfaces together
spin - produces rotation, supination or pronation

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10
Q

injury caused by shear force

A

ligament rupture

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11
Q

2 functions of ligaments`

A

resist tensile forces

proprioception

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12
Q

how do ligaments differ from tendons

A

richer nervous supply and vascular supply

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13
Q

torsion injuries result in

A

spiral fractures

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14
Q

what are the functions of fibrocartilage/menisci

A

distributes load

minimise friction

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15
Q

what causes reduced joint space

A

loss of articular cartilage (focal cartilage destruction)

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16
Q

3 functions of tendons

A

transmit tensile forces
store energy
resist compression and shear

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17
Q

what is the first line pharmacological treatment for OA

A

topical NSAIDS

18
Q

what is active insufficiency

A

inability of muscle to contract enough to produce movement

19
Q

what type of collagen is contained in tendons and ligaments

A

Col I

20
Q

what si the function of hyaline cartilage

A

absorb shock

minimise friction

21
Q

investigations of OA

A

radiograph
inflammatory markers (to exclude RA)
aspiration of synovial fluid (should be clear)

22
Q

how many joints are affected in oligoarthritis

A

2-4 joints

23
Q

how many joints are affected in poly arthritis

A

more than 4

24
Q

what are the symptoms of inflammatory joint disease

A 
early morning stiffness/worse after rest
systemic:
- malaise
-weightloss
- fatigue
-fever
redness of overlying skin
joint effusion and synovial thickening
25
Q

what are the differences between articular and periarticular pain

A

articular:

  • pain all around the joint
  • exacerbated by movements in all directions
  • active and passive movement is equally affected
  • joint line tenderness
  • swelling in the confines of joint capsule

periarticular

  • localised pain in certain directions of movement
  • passive movement easier than active
  • localised tenderness away from jointline
26
Q

what are the symptoms of non-inflammatory disease

A 
pain better with rest
worse with activity
no systemic symptoms
no synovial thickening
may be effusion
27
Q

what is early morning stiffness

A

marked stiffness in the morning and after rest lasting at least 30 mins

28
Q

joint disease pattern off…
60yo male presents with 1yr history of pain and swelling of both knees
symptoms improve with rest and has difficulty walking more than 1 mile

A

chronic non-inflammatory oligoarthritis

29
Q

joint disease pattern of…
30yo female with 3/12 history of progressive pain, stiffness and swelling in the small joints of hands, knees and shoulders
She has early morning stiffneess and improves with activity

A

chronic inflammatory polyarthritis

30
Q

joint disease pattern of
50yo male with 1/52 history of pain redness and swelling in left halux
pain disrupts sleep
unable to weight bear in the morning

A

acute monoarthritis

31
Q

joint disease pattern of…
18yo male 6/12 lower back pain which radiates to back of thighs
pain disturbs sleep at night
experiences back stiffness for 2 hours in the morning
symptoms improve by lunchtime, but feels fatigued

A

chronic inflammatory axial disease

32
Q

name 2 examples of acute inflammatory monoarthritis

A 
septic arthritis
crystal disease (gout/pseudo gout)
33
Q

investigations for suspected septic arthritis

A 
blood cultures
CXR
urine culture
inspection of the skin
ENT exam
CRP
34
Q

name a chronic monoarthritis

A

psoriatic arthritis (coudl also be low grade infections - mycobacterium or fungal)

35
Q

name 4 inflammatory oligoarthritis

A

psoriatic arthrits - +/- sacroilitis + psoriasis
enteropathic arthritis - IBD
ankylosing spnodnylitis - sacroilitis +/- spinal inflammation
reactive arthritis 1-3 wks post infections (gastro, GU, strep throat)

36
Q

clinical features associated with inflammatory oligoarthritis

A 
psoriasis
uveitis
iBD
sacroiliitis
HLA-B27
enthesitis
dactylitis
(pub shed)
37
Q

name 4 examples of chronic polyarthritis

A

RA - symmetrical involvement of MCP PIP and MTPs
connective tissue disorders (SLEs, Sjorgren’s)
Psoriatic arthritis
Chronic polyarticular gout

38
Q

what are the risk factors for septic arthritis

A

prosthetic joints
endocarditis
immunosuppression

39
Q

what are the treatments for septic arthritis

A

aspiration/washout

IV abx for 1/52, then oral 4/52

40
Q

outline some of the changes in cartilage which occur in arthritis

A
  • loss of polyanionic proteoglycans (aggrecan, decor, billycan, fibromodulin)
  • increased proteoglycan catabolism
  • chondrocyte cluster formation
  • breakdown of collagen meshwork
  • surface fibrillation (MMPs and physical destruction)
41
Q

outline some of the biochemical changes in cartilage caused by ageing

A

slowing of cell metabolism
crosslinking
reduced col IX synthesis
changes in aggrecan (shorter CS and more KS)
accumulation of degradation products of cartilage matrix

Movement (8 decks)

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