Osteoarthritis Flashcards
What is osteoarthritis?
A degenerative condition where there is a progressive loss of hyaline cartilage
Typical age of onset of OA
> 50
Risk factors for OA
ObesITY
Joint abnormality
Age >50
Classification of OA
Primary: no other cause
Secondary: secondary to other condition such as obesity
Symptoms of OA
Pain on movement at key joints (knee and hip)
Pain is worse at the end of the day and with movement
Joint stiffening after 30 mins of no use
Decreased ROM
Resulting deformity i.e. bouchards/heberdens/square thumb
Signs of OA
Bouchards in PIPs
Heberdens in DIPs
Thumb squaring
Fixed flexion deformity
Indications on plain radiograph in OA
LOSS
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts
Management of OA
Reduce weight
Increase exercise in all age groups
Analgesia +/- injections
Surgical options in crude wash outs and replacements
When should septic arthritis always be considered?
In any acutely inflamed joint
Which joint is mainly affected by septic arthritis?
Knee >50% cases
Risk factors for developing septic arthritis
Joint disease Diabetes Immunosuppression Chronic renal failure Recent joint surgery Prosthetic joints Extreme upper age
Organisms which cause septic arthritis
- Staph aureus: commoner
- Gonoccus: most common in younger sexually active people
- Gram -ve bacilli
- Streps
Symptoms of septic arthritis
Acutely inflamed joint
-tender, hot and painful
Decreased ROM
Systemically unwell
Urgent investigations to order in septic arthritis
Joint aspiration for MCS of synovial fluid
Radiograph
Bloods: CRP, full differential, ESR, cultures
Main DDx on septic arthritis
Crytsal arthropathy
Reactive arthritis
