Osteoarthritis Flashcards
1
Q
What is it
A
Clinical syndrome of joint pain
2
Q
How common is it
A
Most common joint condition
11% prevalence for hip OA and 24% knee
3
Q
Who is affected by it
A
F>M (3:1)
>50 years
4
Q
What are the causes
A
- Genetics - 40-60%
- Constitutional - age, female, obesity, high bone density, low bone density
- Local, biomechanical - joint injury, occupational/recreational stresses on joints, decrease muscle strength, joint malalignment
5
Q
What is the pathophysiology of OA
A
- Most commonly in peripheral joints = knee, hip, small joints of hand
- characterised by localised loss of cartilage, remodelling of adjacent bone + ass inflammation
6
Q
What are the symptoms
A
- Joint pain - exacerbated by exercise + relieved by rest
- knee pain usually bilateral
- hip pain felt in groin + ant/lat thigh – can be referred to knee or unilateral testicle
- Joint stiffness (morning or after rest)
- decrease function + participation restriction
7
Q
What are the signs of OA
A
- Decrease range of/ pain on movement
- Joint swelling/synovitis (warmth, effusion, synovial thickening)
- Periarticular tenderness
- Crepitus
- Absence systemic features e.g. fever + rash
- Bony swellings + deformity due to OESTEOPHYTES
- Heberden’s nodes - distal interphalangeal
- Bouchard’s nodes - proximal interphalangeal
- Joint instability
- Muscle weakness/ wasting
8
Q
What are some differential diagnosis
A
- Pseudogout
- Psoriatic arthritis
- Septic/rheumatoid arthritis
- Gout
- Ankylosing spondylitis
9
Q
What investigation would you perform
A
- Clinical examination
- Plain x-rays –> osteophytes, joint space narrowing, bone cysts, subarticular sclerosis
- CRP may be slightly elevated
- MRI, joint aspiration (exclude other causes)
10
Q
How do you treat osteoarthritis
A
- Education, strengthening weight loss, assistive device
DRUGS - Topical NSAIDs, capsaicin, paracetamol, opiods, intra-articular, corticosteroids
SURGICAL
- Arthroscopic lavage + debridement/ joint replacement
