Osteoarthritis

Question 1

What are the biochemical factors of osteoarthritis

Answer 1

Abnormal anatomy
Intra-articular fracture
Ligament rupture
Meniscal injury
Occupation - farmers, football players
Persistent heavy activity
Elite running
Obesity

Question 2

What are the features of inflammation in OA

Answer 2

Synovial hypertrophy
Subchondral changes
Joint effusion

Question 3

Pathogenesis of OA

Answer 3

Various factors result in instability/malalignment –> increased load –> microutrauma of joint –> OA joint

Question 4

Diagnosis of OA

Answer 4

45+ years

Acitvity related joint pain plus has either no morning joint-related stiffness or lasts no longer than 30 mins

Question 5

Differential diagnosis

Answer 5

Gout
Other inflammatory arthritides
Septic arthritis
Malignancy

Question 6

Features of OA

Answer 6

Eburnation
Osteophytes
Subchondrial bone cysts
Fibrosed capsule
Pain at rest
Osteophytes
Synovial hypertrophy
Contracted ligaments
Crepitus

Question 7

Management of OA non pharmacological

Answer 7

Thermotherapy
Electrotherapy
Aids and devices
Manual therapy

Question 8

Pharmacological management of OA

Answer 8

Oral analgesic - NSAIDs, paracetamol

Topical treatments - NSAIDS, capsaicin

Question 9

Surgical management of OA

Answer 9

If substantial QOL impact or refractory to non surgical

Joint replacement