Osteoarthritis Flashcards
In whom would you see knee OA? hip? elbow? hand?
mining, farming, jackhammer, cotton mill
How is OA different from DJD?
OA is not a consequence of aging, it’s a repair in response to injury. OA cart does not equal healthy aged cartilage
four proofs OA is an active process
osteophytes, synovial hyperplasia, capsular thickening, initial increase in chondrocyte number
two phases of natural history of OA
compensated and decompensated
four constituents of healthy cartilage
type 2 collagen, aggrecan (hyaluronic acid, GAGs w/ neg charge), EC matrix proteins, chondrocytes
what supports 95% of loading in joints
hydrostatic pressure of interstitial water
what happens to cartilage in OA
loss of collagen and aggrecan. Increased water content.
Major MMPs involved in destruction
collagenase-3 (MMP13), aggrecanase-1 (ADAMTS4)
Joints involved in OA
DIP, PIP, 1st CMC, first foot MTP, knees, hips
how long does morning stiffness last
about 30 min
role of MRI in OA
research, not clinical (except in cases of necrosis, locking, rapid progression)
Tx
NSAIDS. occasional corticosteroid, narcotics for end stage.
