osteoarthritis

Question 1

definition of osteoarthritis

Answer 1

joint disease due to wear and tear. usually female to male is 3:1. usually in people >50 y/o.
usually primary (generalized), but may be secondary to joint disease or other conditions (eg haemochromatosis, obesity, occupational).

Question 2

symptoms and signs

Answer 2

localised disease (usually knee or hip):

• pain and crepitus on movement, worse at the end of the day
• background pain on rest
• joint gelling after 30 mins of rest (stiffness)
• joint instability

generalised disease:

• commonly affected areas - PIP (herberden’s nodes), DIP (bouchard’s nodes), thumb carpometacarpal joint, knees
• joint tenderness, derangement, swelling
• decreased range of movement
• mild synovitis

Question 3

investigations

Answer 3

x-ray: 
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts 

elevated CRP

Question 4

treatment

Answer 4

core treatments:

• exercise to improve muscle strength and aerobic fitness
• weight loss

analgesia:

• paracetamol +/- topical NSAIDs
• codeine +/- short term oral NSAIDs
• topical capsaicin
• intraarticular steroid injections, hyaluronic injections (very expensive)