Osteoarthritis

Question 1

How common is osteoarthritis.

Answer 1

It is the most common articular disease worldwide.

Question 2

What is osteoarthritis.

Answer 2

It is traditionally considered a degenerative disease of articular cartilage.
However, new evidence points towards an inflammatory component, and that the disease involves the entire joint - ie synovium, cartilage and subchondral bone.

Question 3

What is osteoarthritis characterised by. (3)

Answer 3

Progressive cartilage loss.
Subchondral bone formation.
Bony osteophytes.

Question 4

What may osteoarthritis be secondary to. (5)

Answer 4

Trauma. 
Infection. 
Congenital conditions (eg developmental dysplasia of the hip, haemochromatosis. ). 
Occupational. 
Obesity.

Question 5

What are the symptoms of localized osteoarthritis. (5)

Answer 5

Pain after exertion. 
Crepitus. 
Pain worse at end of the day. 
Background pain at rest. 
Joint gelling - stiffness after rest up to 30mins. 
Joint instability.

Question 6

What are the radiographic features of osteoarthritis. (4)

Answer 6

Loss of joint space.
Osteophytes.
Subchondral sclerosis.
Subchondral cysts.

Question 7

What is the mnemonic for the radiographic features of osteoarthritis.

Answer 7

LOSS.

Question 8

What is the ratio of women:men affected by OA.

Answer 8

3:1.

Question 9

What is the typical age of onset of OA.

Answer 9

> 50.

Question 10

Where does localized OA tend to affect. (2)

Answer 10

Hip.

Knee.

Question 11

What are the features associated with generalized OA disease. (6)

Answer 11

Heberden's nodes (nodal OA seen mainly in post menopausal women. Commonly affected joints are the DIP, thumb carpo-metacarpal joints and the knees). 
Joint tenderness. 
Joint derangement. 
Bony swellings (Heberden's nodes at DIP, Bouchard's nodes at PIP). 
Decreased range of movement. 
Synovitis.

Question 12

What may be slightly elevated in the bloods of a patient with OA.

Answer 12

CRP.