Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

Osteoarthritis (OA) is the result of mechanical and biological events that destabilise the normal process of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. It involves the entire joint, including the articular cartilage, subchondral bone, pericapsular muscles, capsule, and synovium. The condition leads to loss of cartilage, sclerosis and eburnation of the subchondral bone, osteophytes, and subchondral cysts.

Question 2

What are the risk factors for osteoarthritis?

Answer 2

Age over 50
Obesity
Knee misalignment
Female
Genetic Factors
High bone mineral density
Physical and manual hobbies and occupation

Question 3

What are the signs and symptoms of OA?

Answer 3

Pain
Functional Difficulties
Movement limitation
Bony deformities
Swelling
Malalignment
Stiffness
Effusion
Antalgic gait

Question 4

How do symptoms of OA differ from rheumatoid?

Answer 4

Activity-related joint pain plus

Has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes

Question 5

What investigations should be done for OA?

Answer 5

X ray
MRI
Serum CRP and ESR
Need to ensure its not RA so do RF, anti CCP antibody

Question 6

What are non pharmacological methods of managing OA?

Answer 6

Thermotherapy
Electrotherapy
Aids and devices
Manual therapy

Question 7

What are pharmacological treatments for OA?

Answer 7

Oral analgesia
Topical analgesia such as capsaicin and NSAIDs, diclofenac
Intra articular injection such as steroids and hyaluronic acid
Duloxetine
Need gastroprotection if taking long term NSAIDs
Surgery-joint replacements