Osteoarthritis Flashcards
What should all patients with OA be advised?
Weight loss and exercise will help
What is the first line for analgesia in OA?
Paracetamol and topical NSAID
Topical NSAID for OA of knee or hand
What is the second line for analgesia in OA?
Oral NSAIDs (+PPI)
+ Weak Opioids such as codeine, dihydrocodeine
Capsaicin creams
Steroid injections
When might surgery be considered for patients with OA?
If conservative methods fail to help and analgesia is inadequate
Why do steroid injections help with OA if it is due to degenerative disease?
Thought to be due to some low level inflammatory process to which the steroids reduce. Inflammation causes inflammatory pain.
What conservative options are avaialble for the management of OA?
Weight loss
Exercise- swimming is a great exercise for people struggling to weight bear
Physiotherapy- muscle strengthening and exercises
Occupational Health Input- Walking aids, supports etch
How should you divide you answer for the management of OA?
Conservative- Exercise, weight loss, physiotherapy, OH input
Medical- 1st Paracetamol + Topical NSAID, 2nd Oral NSAID (+PPI), Topical Capsaicin cream, Weak Opioids- Analgesia according to WHO ladder
Surgical- Joint replacement if significant or prolonged pain without improvements from above options
What are the symptoms of OA?
Pain and stiffness Stiffness follows inactivity Morning stiffness that reduces with 30 minutes Decreased range of movement Crepitations
What changes are seen in the hands of OA patients?
Heberden’s Nodes- DIP
Bouchard’s Nodes- PIP
What X-ray features are seen in OA?
Loss of joint space
Osteophyte formation
Subchondral cysts
Subarticular sclerosis
What blood results are typically seen for osteoporosis?
Typically the blood results are all normal
Normal calcium
Normal PTH
Normal phosphate
Normal ALP
(Unless it is secondary to something else- e.g. renal disease)
