Osteoarthritis

Question 1

physical changes in OA

Answer 1

gradual thinning of cartilage loss of joint space formation of bony spurs (osteophytes) thickening of bone (subchondral sclerosis)

Question 2

what are osteophytes

Answer 2

bony spurs formed in OA

Question 3

typical history of OA

Answer 3

pain following use, improves with rest unilateral symptoms large weight bearing joints (knee, hip)

Question 4

what are nodes at the DIP called

Answer 4

Heberdens nodes

Question 5

what are nodes at the PIP called

Answer 5

Bouchards nodes

Question 6

Patients with OA of knee may suffer from what deformity:

Genu varum or genu valgum?

What is the difference?

Answer 6

genu varum

-bow legged

Question 7

what is a bakers cyst

Answer 7

cyst in popliteal fossa associated with OA

Question 8

How might OA of spine cause sciatica?

What are the symptoms?

Answer 8

osteophytes may impinge on nerve roots

• L4 - S3
• unilateral buttock + leg pain that radiates to foot
• straight leg raise produces pain

Question 9

Xray findings in OA

Answer 9

Loss of joint space

Osteophyte formation

Sclerosis

Subchondral cysts

Question 10

what joints are typically affected in OA

Answer 10

caropmetacarpal joints - base of thumb

DIP

knee

hip

Question 11

are inflammatory markers raise in OA

Answer 11

No- they are normal

Question 12

non-pharmacological management of OA

Answer 12

Exercise to improve strength + joint stability

Pysiotherapy

Reduce weight if overweight

Walking aids

Question 13

1st line drug management OA

Answer 13

paracetemol + topical NSAID (knee + hands only)

Question 15

2nd line drug management OA

Answer 15

oral NSAID + PPI

Question 16

3rd line drug management options OA

Answer 16

Weak opiods

Intra-articular steroid injections

Capsaicin cream

Question 17

indications for a total joint replacement

Answer 17

• severe functional impairment
• severe sleep impairment
• severe radiological changes
• resistent to medical treatment