osteoarthritis

Question 1

what is osteoarthritis

Answer 1

a non inflammatory disorder of moveable joints characterised by a deterioration of articular cartilage & the formation of new bone of the joint surfaces & margins

most common form of arthritis

Question 2

who does osteoarthritis effect?

Answer 2

older
> women
obesity, fracture, occupation, repetitive use and injury associated w some sports

Question 3

cell type responsible for OA

Answer 3

chondrocytes

Question 4

pathogenesis OA

Answer 4

progressive destruction of articular cartilage, exposed subchondral bone becomes sclerotic with inc vascularity & cyst formation
attempts at repair produce cartilaginous growths at the margins of the joint which become calcified

Question 5

clinical features OA

Answer 5

joint pain - worse by movement, relieved by rest

stiffness after rest (gelling) and in contrast to inflam arth, (which is only transient)

Question 6

what joints commonly affected in OA

Answer 6

distal interphalangeal joints (DIPJs)
first carpometacarpal joint of the hands
first metatarsophalangeal joint of the foot
the weight bearing joints: vertebral, hips & knees

Question 7

OA diff from RA? (3)

Answer 7

by pattern of joint involvement
absence of the systemic features in OA
marked early morning stiffness in RA

Question 8

investigations OA

Answer 8

rheum fac -ve
XR only abnormal in advanced dis - narrowing of joint space (from cartilage loss), osteophytes, subchondral sclerosis & cyst formation
MRI = early cartilage changes

Question 9

management OA

Answer 9

obese = lose weight
PHYSICAL: 
strengthening exercises 
local heat or ice packs
bracing devices for support
acupuncture
MEDICAL:
paracetamol + weak opioid e.g. dihydrocodeine
nsaids
intra-articular corticosteroid injections = short term improvement when painful join effusion
SURGERY:
total hip and knee replacement