Osteoarthritis

Question 1

What is the most common type of arthritis in the elderly ?

Answer 1

Osteoarthritis

Question 2

What joints are commonly affected in OA ?

Answer 2

Weight bearing joints: knees, hips and hands (DIPs, PIPs and CMC joints)

Question 3

What is the mnemonic for the 4 main risk factors ?

Answer 3

OFA

1. Obesity, 2. Family history, 3. Female (particularly after menopause) 4.Age

Question 4

What are the 3 other risk factors for OA ? 😂

Answer 4

1. Hyper-mobility 2. Trauma 3. Certain occupations e.g sports

Question 5

What are the 3 main symptoms of OA ?

Answer 5

1. Pain worse on movement/exercise and at the end of the day. If severe may be constant rest pain
2. Stiffness after periods of rest lasting < 30mins
3. Reduced range of movement

Question 6

What are 2 biggest RF and 3 Signs for knee OA ? 😭

Answer 6

RFs: 1. Obesity and 2. Previous trauma or Sport injury’s
Signs: 1. Crepitus, 2. Genu varus 3. Reduced range of movement and Muscle wasting

Question 7

What are 1 biggest RF and 3 Signs for hip OA ? 😭

Answer 7

1. Reduced internal and external rotation
2. Fixed flexion deformity
3. +ve Trendenlenbergs test

Question 8

What are 3 Signs for hand OA ?

Answer 8

1. Bouchard nodes (PIPs)
2. Herberden nodes (DIPs)
3. Squaring of bade of thumb

Question 9

What are the 2 types of OA ?

Answer 9

1. Erosive 2. Crystal associated OA

Question 10

What are the x-ray changes in OA ?

Answer 10

LOSS
Loss of joint space 
Osteophyte formation 
Subchondral sclerosis 
Subchondral cysts

Question 11

What investigations will you do for OA ? (Bloods)

Answer 11

Bloods: FBC, ESR, CRP, RF and anti-CCP

Basic imaging: 2 x-ray views usually lateral and AP

Question 12

Describe the conservative management for OA ? 😭

Answer 12

LOP
Lifestyle: lose weight if overweight and exercise
occupational therapy assistance
Physiotherapy: strengthening exercises

Question 13

Describe the medical management for OA (3) 😭

Answer 13

1st line: PN: oral paracetamol + topical NSAIDs
2nd line: Oral NSAIDs (PPI)+ topical capsaicin)
3rd line: intra-articulat corticosteroid injections

Question 14

Describe the surgical management for OA (3)

Answer 14

Indication: more severe or loss of function 
TAR
1. Total replacement arthroplasty 
2. Arthrodesis 
3. Re-alignment osteotomies (Hip/knee)

Question 15

What are the complications of OA surgery ?

Answer 15

NLPD:
Neurovascular injury 
Leg length discrepancy 
Prosthetic infection 
Dislocation