Osteoarthritis Flashcards
1
Q
Where does osteoarthritis occur?
A
In the synovial joints
2
Q
Risk factors for OA?
A
Obesity Age Occupation Trauma Female Family History
3
Q
OA result of an imbalance of?
A
Cartilage being worn down
Chondrocyte repair
4
Q
4 key x-ray changes in OA?
A
(LOSS) Loss of joint space Osteophytes Subarticular sclerosis Subchondral cysts (fluid filled holes in bone)
5
Q
Do x-ray changes correlate with symptoms in OA?
A
Not necessarily, may have significant x-ray findings but be asymptomatic
6
Q
Presentation in OA?
A
Joint pain and stiffness Worsened by activity (contrast to inflammatory arthritis) Deformity Instability Reduced function of joint
7
Q
Joints commonly affected in OA?
A
Hips Knees Sacroiliac joints DIP joint (Distal-interphalangeal) MCP joint at base of thumb Wrist Cervical spine
8
Q
Signs of OA in the hands?
A
Heberden's nodes (DIP joints) Bouchard's nodes (PIP joints) Squaring at the base of thumb at carpometacarpal joint Weak grip Reduced range of motion
9
Q
Diagnosis of OA?
A
Can be made without investigations if:
- Over 45
- Typical activity related pain
- No morning stiffness (or stiffness lasts less than 30 minutes)
10
Q
Management of OA?
A
Patient education Lifestyle changes Physiotherapy Occupational therapy to support activities Stepwise analgesia
11
Q
Stepwise analgesia in OA?
A
- Oral paracetamol and topical NSAIDs
- Add oral NSAIDs (plus PPI to protect stomach)
- Consider opiates (use with caution due to side effects)
12
Q
Provides temporary relief of inflammation and improves symptoms in OA?
A
Intra-articular steroid injections
13
Q
Severe cases of OA?
A
Consider joint replacement
