Osteoarthritis

Question 1

Nodes on the PIP joint

Answer 1

Bouchards Nodes

Question 2

Nodes on the DIP joint

Answer 2

Heberdens Nodes

Question 3

Most common site for OA

Answer 3

Big toe –> Bunnion

Question 4

What are Osteophytes?

Answer 4

Tufts of Bone that grow out from just under the joint.

Question 5

What is subchondral sclerosis?

Answer 5

Subchondral sclerosis is the bone growth under the cartilage on the joint plane –> pain and Numbness

Question 6

Where does OA hip pain manifest?

Answer 6

Buttock to groin. No involvment of the lateral compartment of the leg.

Question 7

OA symptoms

Answer 7

Joint line pain
Crepitus
Limited movement
Occassional swelling

Question 8

OA definition

Answer 8

Osteoarthritis OA is a degenerative disease of joints, characterized by
•Breakdown of articular cartilage
•and proliferative changes of surrounding bones
•It is a chronic disease of the musculoskeletal system,without systemic involvement “mechanical”.
•OA is mainly a non-inflammatory disease of synovial joints

Question 9

Epidemiology of OA

Answer 9

Found in 90% of the population to varying degrees.
Its is the most Common joint disease.
OA of the knee can be found in 70% of >60 yrs old

Question 10

Primary Osteoarthritis?

Answer 10

Unknown aetiology

Age > 40yrs old
Sex Female > male 4:1 (except in hip OA M>F)
Obesity
Genetics
trauma (daily)

Question 11

Secondary Osteoarthritis?

Answer 11

Known Aetiology

• Trauma
• Previous joint disorders;
• Congenital hip dislocation
• Infection: Septic arthritis, Brucella, Tb
• Inflammatory: RA, AS
• Metabolic: Gout
• Hematologic: Hemophilia
• Endocrine: DM

Question 12

Pathalogical changes during OA

Answer 12

Focal destruction of cartilage (areas of increased load)
•Sclerosis of subchondral bone
•Subchondral cysts
•Marginal osteophytes

Question 13

Clinical features

Answer 13

Joint line tenderness/pain
Crepitous
Limited movement
occasional effusion

Question 14

OA at one site is called?

Answer 14

Monoarthritis

Question 15

OA at 2-4 sites is called?

Answer 15

Oligoarthrisit

Question 16

OA at more than 4 sites?

Answer 16

Polyarthritis

Question 17

Non-pharmacological management of OA

Answer 17

Patient education
•Weight loss
•Identify and treat depression
•Exercise –strengthen muscles
•Adaptive devices
•Support devices

Question 18

Pharmacological management of OA

Answer 18

Paracetamol!!! over 2-3 months ODS to build effective treatment.
Also NSADIS (risk of stroke (clotting), GI issues Raised BP)
Opioids
Corticosteroids

Question 19

Surgical intervention

Answer 19

For those who fail on anagesic intervention.

Must have impact on quality of life

Question 20

pain gets worse as days progresses?

Answer 20

OA

Question 21

Pain gets better as day progresses

Answer 21

Rheumatoid Arthritis

Question 22

Acute onset of symptoms

Answer 22

Inflamatory cause

Question 23

Chronic onset of symptoms

Answer 23

Mechanical cause

Question 24

what is septic arthritis?

Answer 24

Septic arthritis is inflammation of a joint caused by a bacterial infection.

Question 25

What is crystal arthritis?

Answer 25

Gout - defective metabolism of uric acid causes arthritis

Question 26

Psoriatic arthritis (PsA)

Answer 26

Psoriatic arthritis is a type of arthritis that develops in some people with the skin condition psoriasis

Question 27

Ankylosing spondylitis

Answer 27

a form of spinal arthritis, chiefly affecting young males, that eventually causes ankylosis of vertebral and sacroiliac joints.

Question 28

SeroNegative arthritis

Answer 28

Not sero positive - 70% of pop with RA are sero+

Question 29

Rheumatoid arthritis

Answer 29

a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles.