osteoarthritis Flashcards
what is the definition of osteoarthritis?
Progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of body spurs and cysts in the margins of the joints
What is the most affected component of bone in OA?
the articular cartilage
How is the articular cartilage affected?
increased swelling
change in colour
cartilage fibrilation
cartilage erosion down to subchondral bone
what are the differences between a normal joint and an OA joint?
Thickened capsule cyst formation sclerosis of the sunchondral bone shelving "fibrillated" cartilage osteophytic lipping synovial hypertrophy altered contour of bone
What is the pathogenesis of OA?
water content decreases
proteoglycan synthesis
collagen cross linking
size of aggrecan, GAG and hyaluronic acid
How many sufferers are there of OA?
8 million
What age are most OA patients?
over 45
Where does OA most commonly occur?
Ends of fingers, thumbs, neck, lower back, knees and hips
What are the 2 types of OA?
Primary and secondary
What are the 4 causes of secondary OA?
trauma
hip dysplasia
infection
diabetes
How is OA diagnosed?
Clinical history, Xray
What might patient present with?
pain decreased walking distance sleep disturbance limp - trandelenburg sign stiffness
What would an OA joint look like in Xray?
joint space narrowing
osteophytes
sunchondral sclerosis
cyst formation
What are the goals for managing OA?
decreasing pain
increasing range of motion
increasing muscle strength
What are the non-operable treatments for OA?
Pain managements - NSADs, paracetamol Alternative medications - glucosamine, chondroitin sulphate Physiotherapy walking aids joint injections
What are the surgical treatments for OA?
Arthroscopy
joint replacement surgery
cartilage tranplant
What are the key symptoms of OA?
pain, especially when doing weight-bearing activities such as walking
short-lived stiffness in the morning
difficulty moving affected joints
What are the systemic risk factors of OA?
age - tenfold increase from 30 to 65
genetics
gender
nutritional - low vitamin c and d intake
What are the joint biomechanics Risk factors of OA?
joint trauma obesity occupation abnormal joint biomechanics - dysplasia, malalignment, instability knee extensor weekness sports with joint risk
