Osteoarthritis Flashcards
1
Q
What is the commonest form of joint problem?
A
Osteoarthritis
2
Q
How is osteoarthritis defined?
A
-Tear, flare and repair
3
Q
What are the key processes of osteoarthritis?
A
- Trauma and mechanical imbalance
- Inflammation and pain
- Repair processes around the joint
4
Q
What biochemical factors are there?
A
- Abnormal anatomy (DDH)
- Intra-articular fracture
- Ligament rupture
- Meniscal injury
- Occupation – farmers, football players
- Persistent heavy physical activity
- Elite running
- Obesity
5
Q
What contributes to inflammation?
A
- Synovial hypertrophy
- Subchondral changes
- Joint effusion
6
Q
What biochemical mediators are elevated in OA?
A
- IL-1B
- TNFa
- MMPs
7
Q
What is the pathogenesis of OA?
A
- Muscle weakness, ligament injury or abnormal anatomy on lead to instability and ,misalignment
- Instability and obesity increase the load and lead to joint microtrauma
- Formation of OA joint and synovitis
8
Q
What is the criteria for an OA diagnosis?
A
- 45 years +
- Activity-related joint pain plus
- Has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes
9
Q
What symptoms suggest it isn’t OA and another cause should be looked for?
A
- Trauma
- Prolonged morning stiffness
- Rapid deterioration of symptoms
- Hot, swollen joint
10
Q
What is the differential diagnosis for OA?
A
- Gout
- Other inflammatory arthritides
- Septic arthritis
- Malignancy
11
Q
What non-pharmacological treatments are there for OA?
A
- Thermotherapy
- Electrotherapy
- Aids and devices
- Manual therapy
- NICE do not recommend: acupuncture, nutraceuticals (glucosamine, chondroitin)
12
Q
What pharmacological treatments are there for OA?
A
- Oral analgesia: paracetamol, NSAIDs
- Topical treatments: NSAIDs, capsaicin (knee, hand)
13
Q
When should OA be referred to surgery?
A
- Substantial impact on quality of life
- Refractory to non-surgical treatment
- Referral letter
14
Q
What radiological findings are there in OA?
A
- Joint space narrowing
- Subchrondral sclerosis
- Cysts
- Osteophyte formation
