Osteoarthritis Flashcards
Definition of osteoarthritis
Degenerative joint condition characterised by joint pain, stiffness, swelling and deformity
Four elements that characterise osteoarthritis
Articular surface degeneration- subchondral bone exposed
Formation of new bone (attempt at healing) - osteophytes and subchondral sclerosis
Microfracture of articular surface - cyst formation
What causes osteoarthritis
Repeated microtrauma or abnormal biochemical forces causing damage to the weight baring cartilage surface, wearing it away
Primary or secondary osteoarthritis
Primary - no underlying causes found
Secondary - clear predisposing factor such as trauma, congenital, developmental or metabolic disease
Risk factors for primary osteoarthritis
Obesity Female gender Occupation Muscle weakness Lack of osteoporosis Acromegaly Calcium crystal deposition disease
Clinical features of osteoarthritis
Pain - Burning or aching commonly localised to a single joint - Gradual, progressive, asymmetric pain over many years - worse after activity - relived by rest Single or multiple joint Swelling Deformity Stiffness Weakness Joint line tenderness Crepitus Diminished range of movement Heberden's and Bouchard's nodes
Radiographic findings of osteoarthritis
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts
What are the core, non pharmacological treatments for osteoarthritis
Exercise to improve local muscle strength and general aerobic fitness Weight loss if overweight PT and OT Walking aids TENS, heat or cold pads for pain
Pharmacological management for osteoarthritis
Regular paracetamol and topical NSAIDs THEN Codeine or short-term oral NSAIDs (+PPI) IF SEVERE Intra-articular corticosteroid injections to temporarily relieve pain OTHER Topical capsaicin Intra-articular hyaluronic acid injections Glucosamine and chondroitin products
Breifly describe management for osteoarthritis
Physiotherapy
Exercise and weight loss
Analgesia
Surgery - joint replacement if severe and affecting QoL
