Osteoarthritis Flashcards
pathogenesis of osteoarthritis
“tear, flare and repair”
joint is damaged, it inflames and repairs itself. This process on repeat creates a rugged joint, thin cartilage and narrowed joint space
causes of joint damage in osteoarthritis
abnormal anatomy intra-articular fracture obesity menisceal tear ligament rupture heavy physical activity
what cytokines mediate the inflammation in osteoarthritis
IL-1, IL-6, TNF-alpha and MMPs
where does hip osteoarthritis pain refer to
groin, anterior lateral thigh, knee or testicle
true/false for a diagnosis of osteoarthritis any morning stiffness must last no longer than 30 mins
TRUE - any longer indicated RA
diagnostic criteria for osteoarthritis
> 45 y/o
activity related joint pain
no morning stiffness or <30 mins
give 4 differentials for osteoarthrits
RA, septic arthritis, gout and malignancy
what signs are seen in osteoarthritis hands
Bouchard’s nodes and Heberden’s nodes
true/false - the pain in osteoarthritis is worse after activity
TRUE - differs for inflammatory arthritides
true/false - pain may be present at rest and at night in advanced osteoarthritis
TRUE
feature of osteoarthritis on x-ray
osteophytes
space narrowing
bone cyts
subarticular sclerosis
best investigation to show osteoarthritis
x-ray
what conditions could you exclude from the differential by a joint aspiratoin
septic arthritis
gout
what baseline measurements do you not take before starting treatment:
a) FBC
b) BMI
c) LFTs
d) creatinine
e) O2 sats
e) - O2 sats
pharmacological treatments
paracetamol and NSAIDs
topical capsaicin
intra-articular corticosteroid
surgical treatments
joint replacement
indications for surgery
significant impact on QoL or not responding well to non-surgical treatment
non-pharmacological treatments
thermotherapy
electrotherapy
aid and devices
manual therapy
lifestyle advice
exercise and weight loss
1st line treatment in osteoarthritis
holistic approach with self-management, information, exercise and weight loss
