Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rheumatology > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Describe the following joints:

  1. Fibrous/Bony?
  2. Cartiaginous?
  3. Synovial? 3
A
  1. Fibrous/Bony
    - Minimal to no motion
  2. Cartilaginous
    - Limited motion
  3. Synovial
    - Freely mobile
    - Comprised of 2 or more bones
    - May have a meniscus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the following shape/anatomy:

  1. Hip? 2
  2. Shoulder? 2
  3. Knee? 2
  4. Ankle?
A
  1. HIP
    - Ball and socket
    - Lots of motion, stable
  2. SHOULDER
    - Ball on small tee
    - More motion, less stable
  3. KNEE
    - Round condyles on flat surface
    - Ligaments essential
  4. ANKLE
    - Limited plane of motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Whats the most common form of arthritis? Also the leading cause of chronic disability.

A

OSTEOARHTRITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Osteoarthritis:

  1. AKA?
  2. PP?
  3. Symptoms? 5
  4. What can you develop?
  5. How will the muscle and ligament be affected?
A
  1. aka: degenerative arthritis or joint disease; osteoarthrosis
  2. Loss of articular cartilage - - > exposed bone
    • Pain, tenderness,
    • stiffness,
    • effusion,
    • loss of motion,
    • creaking
  4. Can develop progressive deformity
  5. Muscular atrophy & ligamentous laxity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PREDISPOSING FACTORS
for OA?
7

A
  1. Age,
  2. female sex (except around the age of 45),
  3. previous injury
  4. Obesity, especially for knees
  5. Heavy physical labor
  6. Positive family Hx
  7. Sports activities

Running does not appear to increase the risk
Monitor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PP of OA:

  1. In most patients, the trigger is damage to what?
  2. What react by releasing degradative enzymes?
  3. Can be caused by what kind of trauma?
    - Leads to further cartilage damage
  4. Bone reacts with what? 2
    - Degradation of cartilage and bony reaction
  5. Superficial erosions → complete what?
  6. Joint space __________ and possible deformity
  7. Hypertrophy/hyperplasia of osteocytes → subchondral sclerosis→ what?
A
  1. normal articular cartilage
  2. Chondrocytes
  3. macro-trauma or repeated micro-trauma
  4. subchondral sclerosis and osteophytes
  5. loss of cartilage
  6. narrowing
  7. osteophyte formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features of OA: 5

What areas of the body usually? 4

A
  1. Joint pain,
  2. swelling,
  3. crepitation,
  4. tenderness,
  5. effusions
  6. Hands,
  7. hips,
  8. knees,
  9. spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. What kind of pain do you want to be aware of?
  2. What are late signs?
  3. What kind of joint involvement in older pts?
  4. Middle aged?
  5. Young pts?
    (from what?)
A
  1. Beware radiating pain and bursitis
  2. Tenderness on palpation and on passive motion are late signs
  3. Multiple joint involvement in older patients
  4. Hip and knee involvement seen in the middle aged
  5. Single joint involvement in the young (trauma or congenital abnormality)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common joint affected for OA?

A

Hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

OA Hands

  1. What population mostly?
  2. Genetic?
  3. Which joints? 2
  4. What are the osteophytes at each of these called? 2
A
  1. Middle-aged and elderly women
  2. Strong family history
  3. DIP and PIP joints of fingers
  4. Osteophytes and palpable
    - Heberden’s nodes (DIP)
    - Bouchard’s nodes (PIP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

OA shoulder:

  1. Will present how?
  2. Difficulty with what activities? 3
  3. Often associated with what? 2
A
  1. Progressive anterior shoulder pain, worse with motion
  2. Difficulty with
    - overhead activities,
    - sleeping,
    - axillary hygiene
  3. Often seen with
    -rotator cuff disease/tears,
    -AC joint arthritis
    (Spurs and AC arthritis can cause impingement of rotator cuff)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

OA hip

  1. Will present how?
  2. Can radiate where?
  3. Pain on lateral side of hip is usually what?
  4. Pain behind hip usually from where?
  5. Starts how and progresses to what?
  6. Difficulty with what movements?
  7. Pain with what?
A
  1. 10% of patients – pain deep in groin
  2. Can radiate to anterior thigh, knee and buttock
  3. Pain on lateral side of hip, usually greater trochanteric bursitis
  4. Pain behind hip, usually from back
  5. Starts with prolonged standing/walking can become intolerable
  6. Difficulty putting on shoes/socks – pain and loss of motion
  7. Pain with abduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

OA knee

  1. What is a contributing factor?
  2. Characterized by? 4
  3. Difficulty with what actions? 3
  4. Pain with what movements?
  5. Imaging? 2
A
  1. 30% of patients – obesity is a contributing factor
    • Osteophytes,
    • effusions,
    • crepitus, and
    • limited motion
  3. Difficulty:
    - doing stairs,
    - getting out of low chairs,
    - off of toilets
  4. Pain with kneeling/squatting – hard to get off the ground
  5. Imaging – get
    -standing views (AP and 45 degree) and
    -sunrise view
    Supine AP and lateral not adequate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

OA spine

  1. Symptoms are from what? 2
  2. Cervical symptoms? 2
  3. Can develop what?
  4. Lumbar symptoms? 2
  5. Can develop what?
A
  1. Symptoms from
    - facet joint arthritis and
    - DDD
  2. Cervical:
    - pain and stiffness,
    - aching pain down the arm
  3. Can develop cervical cord compression
  4. Lumbar:
    - pain across low back/buttocks
    - with LOM flex/ext
  5. Can develop spinal stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dx of OA

What will we see on xray that would indicate this? 5

A
  1. Joint space narrowing
  2. Surface irregularity
  3. Osteophytes
  4. Subchondral sclerosis
  5. Subchondral cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

OA NONPHARMALOGIC RX

6

A
  1. Moderate weight loss
  2. Exercises
  3. PT/OT
  4. Braces
  5. Heat/Cold
  6. Rest
17
Q

OA PHARMALOGIC RX

5

A
  1. Acetaminophen
  2. NSAIDs (Naproxen/Ibuprofen)
  3. Tramadol
  4. Opioids
  5. Intraarticular injections
18
Q

OA INTRAARTICULAR INJECTIONS

  1. Both what have been shown to be effective? 2
    - Can provide months of relief for many patients
A
  1. steroids and hyaluronans
19
Q

Glucocorticoids (triamcinolone, methylprednisolone) injections?

  1. MOA?
  2. Often used where? 2
  3. How many can you do?
  4. Complications? 3
A
  1. Slow cartilage degradation, provide pain relief
  2. Often used in
    - knee and
    - shoulder, less in other joints
  3. Repeated injections have been proven safe
    • Post injection flare,
    • feeling high,
    • possible infection
20
Q

Hyaluronans (synvisc, hyalagen) injections

  1. What are they?
  2. Have been used for what? 2
  3. Disadvantgaes? 3
A
  1. Macromolecules that absorb water and may protect cartilage
  2. Have been used for
    - knees and
    - hips
    • Series of injections,
    • can have a flare,
    • possible infection
21
Q

KNEE INJECTION/
ASPIRATION
Steps in the process
6

A
  1. Thorough skin prep
  2. Supero-lateral portal (Not antero-medial)
  3. Patient supine
  4. Sit with knee at eye level (Little pain when slow)
  5. Numbing skin (Usually not needed)
  6. Aspiration/Injection
22
Q

REVIEWS OF NON-SURGICAL Rx
FOR ARTHRITIC KNEE PAIN
1. The following have been shown to help? 3

  1. The folllowing have not? 5
A
  1. These have been shown to help
    - Intra-articular steroids and hyaluronans
    - Gentle exercises, swimming, ice
    - Weight loss
  2. Studies show these have not helped
    - Orthotics
    - Taping
    - Acupuncture
    - Glucosamine and chondroitin
    - Arthroscopic debridement
23
Q

OA SURGICAL TREATMENT

3

A
  1. ARTHROSCOPIC PROCEDURES
  2. TOTAL JOINT REPLACEMENT
  3. CHONDROCYTE GRAFTING
24
Q

OA SURGICAL TREATMENT

  1. ARTHROSCOPIC PROCEDURES may cause what complication?
  2. TOTAL JOINT REPLACEMENT: What is it?
  3. CHONDROCYTE GRAFTING: Possibly useful for what?
A
  1. May aggravate underlying arthritis
    - No studies that show patients do any better
  2. Unicompartmental replacement and resurfacing more controversial
  3. Perhaps for small, isolated defects.
    - No long term studies
25
Q

What is the Gold standard for severe knee, hip, or shoulder joint arthritis?

A

TOTAL JOINT REPLACEMENT

-Not as clear cut for ankle, wrist, elbow

26
Q

Total Knee Replacement:

  1. Advantages? 3
  2. Disadvantage? 1
A
    • Relieves pain,
    • corrects deformity,
    • improves function
  2. Requires significant post-op rehabilitation
27
Q

TOTAL HIP REPLACEMENT

  1. Advantages? 3
  2. Disadvantage? 1
  3. Total shoulder replacement advanatges? 2
A
    • Relieves pain,
    • restores function
    • Relatively quick recovery – out-pt
  2. Leg length inequality not uncommon
    • Relieves pain,
    • may improve function
28
Q

LONG TERM ISSUES OF REPLACEMENTS

3

A
  1. Infections
  2. Loosening
  3. Periprosthetic
29
Q

LONG TERM ISSUES OF REPLACEMENTS
INFECTIONS:
1. More susceptible due to implant – examples? 2
(Use Heart Association guide lines for prophylaxis)
2. ________ pain, look for infection

LOOSENING

  1. May be due to what? 2
  2. Follow up how?

PERIPROSTHETIC FRACTURES

  1. Metal creates what?
  2. Difficult to treat. Avoid what?
A
    • dental procedures,
    • colonoscopy
  2. Sudden
    • bone resorption or
    • macrophage response
  4. x-rays
  5. stress risers
  6. contact sports

Rheumatology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions