OSTEOARTHRITIS Flashcards

1
Q

Define osteoarthritis.

A

Degenerative disease of the articular cartilage and subchondral bone.

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2
Q

What are the causes of primary osteoarthritis?

A

Congenital misalignment of bone
Mechanical injury in the joint
Obesity (perhaps metabolic reasons rather than just increased weight)
Loss of strength in muscles supporting a joint
Impairment of peripheral nerves, leading to sudden or uncoordinated movements.
Genetics have been found to be a factor
Post-menopause

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3
Q

What are the causes of primary osteoarthritis?

A

Congenital misalignment of bone
Mechanical injury in the joint
Excessive weight
Loss of strength in muscles supporting a joint
Impairment of peripheral nerves, leading to sudden or uncoordinated movements.
Genetics have been found to be a factor
Post-menopause

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4
Q

What is complete loss of the articular cartilage described as?

A

Eburnation

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5
Q

What is it called when synovial fluid makes its way into the bone?

A

Subchondral pseudocyst

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6
Q

What are the five subtypes of osteoarthritis?

A
Nodal generalized
Erosive inflammatory 
Large joint
Crystal associated
...
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7
Q

What are the different stages of the degeneration?

A

Fibrillation
Chondrocyte clusters
Thinning of cartilage
Eburnation

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8
Q

Is osteoarthritis an inflammatory disease?

A

No (despite its name)

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9
Q

What are the causes of secondary osteoarthritis?

A

Alkaptonuria - genetic disorder where the body cannot process phenylalanine and tyrosine.
Congenital disorders of joints
Diabetes
Ehlers-Danlos Syndrome
Hemochromatosis
Wilson’s disease - accumulation of copper in tissues
Perthes’ disease - childhood hip disorder where blood flow to the ball of the femur is disrupted.
Lyme disease - tick borne disease involving bacteria Borrelia
Costochondritis
Gout
Rheumatoid arthritis
Marfan’s syndrome - connective tissue disorder
Septic arthritis
Obesity (more than just excess body weight, metabolic effects are also a factor)

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10
Q

What is the process of damage to cartilage called?

A

Ochronosis

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11
Q

What is the pathophysiology of osteoarthritis?

A

Collagen matrix becomes more disorganised

Decrease in proteoglycan content within cartilage but outweighed by breakdown of collagen fibres. This leads to a net increase in water content.

Without protective features of proteoglycans, collagen fibres further degrade, leading to more damage.

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12
Q

How would a patient with suspected osteoarthritis present? (Name 3 symptoms)

A

Joint pain
Loss of ability
Crepitus
Pain worse in cold weather

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13
Q

On examination, what might you find in a patient with suspected osteoarthritis?

A
Crepitus upon moving the joint
Heberden's nodes
Bouchard's nodes
Bunions
Joint effusion in the knee
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14
Q

What is crepitus?

A

Crackling noise when moving affected joint.

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15
Q

Which joints are most commonly affected in patients with osteoarthritis?

A
Hands
Feet
Spine
Hips
Knees
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16
Q

What are Heberden’s nodes?

A

Osteophytes in the DIP

17
Q

What are Bouchard’s nodes?

A

Osteophytes in the PIP

18
Q

How can might you distinguish between osteoarthritis and rheumatoid upon examining a patient’s hands?

A

Rheumatoid arthritis does not affect the DIP, therefore no Heberden’s nodes will form. Other rheumatoid arthritis signs such as ulnar deviation are also not seen in osteoarthritis.

19
Q

Are Bouchard’s nodes seen in rheumatoid arthritis?

A

Yes. They are seen in both osteoarthritis and rheumatoid arthritis.

20
Q

What might you see on a radiograph of a joint from a patient with osteoarthritis?

A

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

21
Q

What are the management options for someone diagnosed with osteoarthritis?

A
Weight loss
Exercise
Paracetamol
NSAIDs
Cox-2 selective inhibitors (celecoxib)
Oral opioids (tramadol)
Topical NSAIDs (diclofenac)
Joint replacement
22
Q

What makes up cartilage?

A

Made up of chondrocytes which produce large amounts of extracellular matrix.

23
Q

What is the extracellular matrix that makes up cartilage made of?

A

Collagen fibres
Proteoglycan
Elsatin fibres

24
Q

What are the three types of cartilage and what is the main component of the extracellular matrix in each one?

A

Elastic cartilage - elastin
Hyaline cartilage - collagen type II
Fibrocartilage - collagen type I and II

25
Q

What is the name of the cells from which chondrocytes are derived?

A

Chondroblasts