Brainscape's Knowledge GenomeTM

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


See full index

CP3 @ UoN - Musculoskeletal & MDD > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

What is the most common type of arthritis?

A

Osteoarthritis

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

What causes Osteoarthritis?

A

Results from disparity b/w stress applied to articular cartilage & ability of cartilage to withstand that stress

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

What joints are commonly affected by OA?

A 
Hip
Knee
DIP
PIP
Thumb CMJ
Hallux MTP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which joint is classically spared in OA?

A

MCPJs

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

How does OA present?

A 
Progressive pain
   -initially activity related, finally constant rest pain
Stiffness
   -worse after periods of rest, lasts <30mins
Waxing/waning course
Later features
   -muscle wasting
   -loss of mobility
   -deformity/joint instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the signs on examination of OA?

A

LOOK - bony swelling, muscle wasting
FEEL - joint line tenderness, possible effusion, crepitus
MOVE - limited range of movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the risk factors for OA?

A 
Age
Obesity
Family hx
Gender (polyarticular Oa more common in women, esp post menopause)
Hypermobility
Prev trauma
Occupation (miners, farmers etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the protective factors for OA?

A

Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of 2o OA?

A 
Pre-existing joint damage
   -inflam/septic/crystal arthritis
   -AVN
   -trauma
Metabolic disease
   -acromegaly
   -chondrocalcinosis
   -haemochromatosis
Systemic disease
   -haemophilia
   -haemaglobinopathies
   -neuropathies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two main types of OA?

A

Localised (hip/knee OA)

Generalised (affects many joints)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the aetiology of Hip OA?

A

More common in males

Unilateral at presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the signs on examination of Hip OA?

A

Painful & decreased internal/external rotation of hip

Trendelenburg +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Trendelenburg test?

A

Indicates weakness in hip abductors

  • pelvis drops on contralateral side during single leg stand on the affected side
  • sound side sags
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the prognosis of Hip OA?

A

Does poorly

Requires arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors for Knee OA?

A

Obesity
Prev trauma
Knee soft tissue injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs on examination of Knee OA?

A 
Often bilateral
Moderate effusion
Decreased range of movement
Crepitus
Quadriceps wasting
Genu varus deformities due to medial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the common subtypes of generalised OA?

A

Nodal Generalised OA
Erosive OA
Crysal Associated OA

18
Q

How does Nodal Generalised OA present?

A

Joints of hand affected over many years
-classically presents in postmenopausal women
First presents w/ painful swelling & impairment of funcn

19
Q

What are the risk factors for Nodal Generalised OA?

A

Gender (f)
Post-menopause
Familial tendency (AI)

20
Q

Which joints does Nodal Generalised OA commonly affect?

A

DIPS > PIPS

21
Q

What is the natural hx of Nodal Generalised OA?

A

Joints in hands affected over many years
-painful swelling & impairment of function
Inflammatory phase settles after months/yrs
-leaves bony swellings posterolaterally
-Heberdens (DIPS) & Bouchards (PIPS) nodes
-function still generally good

22
Q

What joints are affected to cause the classical ‘squared hand’ of OA?

A

CMC & MCP joints of thumb
Bony swelling
Fixed adduction

23
Q

What is Erosive OA?

A

Rare type of OA
Characteristic cysts seen on XR
Poor prognosis

24
Q

What is Crystal Associated OA?

A

Calcium pyrophosphate deposition in cartilage leading to chondrocalcinosis (pseudogout)

  • can be asymptomatic/lead to sx of OA
  • knees/wrists most commonly affected
25
Q

What is the best predictor of pain in OA?

A

Poor quadriceps strength & depressed mood

-better than radiological severity

26
Q

How does Early OA present?

A

Rarely symptomatic

-unless accompanied by effusion

27
Q

What is the underlying pathophysiology of OA?

A

Wear/tear splits/erodes articular cartilage
-narrows joint space
Associated inflammation
-thickening of joint capsule/synovium
-capsular fibrosis
Progressive loss of cartilage leads to eburnation
Cysts develop beneath abnormal bone surface
Osteophytes form on peripheral, unstressed, cartilage
2o atrophy of associated muscles

28
Q

What is Eburnation?

A

Constant friction of two naked bone surfaces rubbing together

29
Q

What are the four cardinal changes of OA on X-ray?

A

Joint space narrowing
Sclerosis
Osteophyte formation
Cystic formation

30
Q

What investigations may be appropriate in suspected OA?

A

Bloods - CRP/ESR, RF, ANA (rules out other dx)
XR - 2 views to confirm dx
CT/MRI - if XR doesn’t match clinical picture

31
Q

What is the conservative management of Early OA?

A 
Pt education
Wt loss
Physiotherapy
Reduction of mechanical factors (cushioned footwear, walking aids)
Splints for ankles/wrists
Offset bracing of knee
32
Q

What is the medical management of OA?

A

Pain-relief

  • paracetamol & topical NSAIDs
  • oral NSAIDs (+PPI) & topical capsaicin
33
Q

What are the surgical management options for OA?

A 
Total replacement arthroplasty
   -common in knee/hip
   -delayed for longer in knee (poor outcomes)
One compartment arthroplasty
   -can occur in knee if just one side of articular surface is diseased
Arthroscopy &amp; joint washout
   -for young pts
   -delays definitive management for mo/yrs
Arthrodesis
   -ankle/spine/hand
Realignment osteotomies
   -hip/knee
34
Q

What are the indications for large joint replacement surgery?

A

Pain/stiffness leading to loss of function

35
Q

What are the absolute contraindications to large joint replacement surgery?

A

Untreated joint sepsis

36
Q

What are the relative contraindications to large joint replacement surgery?

A

Young age

Co-morbid disease inc obesity

37
Q

What are the potential complications of total hip replacement?

A

Leg length discrepancy (15%)
Dislocation (3%, highest in 1st 3mo, can be due to infec)
Infection (0.5-1%)
Periprosthetic fracture
Persistent pain (1%)
Polyethene wear of acetabular compartment
Neurovascular injury (0.1%)

38
Q

How does infection post total hip replacement present?

A

Subclinically w/ little systemic upset

39
Q

How is suspected infection post total hip replacement confirmed?

A

Aspiration in aseptic conditions

-ideally on 3 occasions

40
Q

How is infection post total hip replacement managed?

A

Removal of prosthesis

Lengthy courses of a/b

41
Q

What is the prognosis of infection post total hip replacement?

A

Rare but devastating

Joint salvage rates around 30%

CP3 @ UoN - Musculoskeletal & MDD (26 decks)

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