Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

Most common arthropathy

Progressive loss of articular cartilage and remodelling of underlying bone

Question 2

Pathophysiology of osteoarthritis

Answer 2

Degradation of cartilage and remodelling of bone due to active response of chondrocytes

Chondrocytes release enzymes - break down collagen and proteoglycans

Exposure of underlying bone results in sclerosis - followed by active remodelling by osteophytes

Question 3

Clinical features of osteoarthritis

Answer 3

Pain and stiffness
Progressively worse

Worsens with activity

Question 4

Most commonly affected joints by osteoarthritis

Answer 4

Small joints - hand and feet
Hip
Knee

Question 5

What are Bouchard nodes?

Answer 5

Swelling of PIPJs in hands

Question 6

What are Heberden nodes?

Answer 6

Swelling of DIPJs in hands

Question 7

What deformity is common in knees affected by osteoarthritis?

Answer 7

Varus deformity

Distal leg inwards

Question 8

X-ray features of osteoarthritis

Answer 8

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

Question 9

Conservative management of osteoarthritis

Answer 9

Education about condition

Strengthing and exercise

Obese patients = weight loss

Question 10

Medical management of osteoarthritis

Answer 10

Simple analgesics
Topical NSAIDs

Intra-articular steroid injections

Question 11

Surgical management of osteoarthritis

Answer 11

Joint replacement