Osteoarthritis Flashcards
How does osteoarthritis occur?
Trauma & mechanical imbalance
Inflammation & pain
Repair processes around joint
What are biomechanics factors that can lead to OA?
Abnormal anatomy Intra-articular fracture Ligament rupture Meniscal injury Occupation Persistent heavy physical activity Elite running Obesity
What is OA?
A condition that results from the loss of cartilage at synovial joints, and is often accompanied by degeneration of the underlying bone.
What types of inflammation occur in OA?
Synovial hypertrophy
Subchondral changes
Joint effusion
What is the pathogenesis of OA?
Muscle weakness/ligament injury/abnormal anatomy -> obesity/instability/malalignment -> increased load -> joint micro trauma -> OA joint
How is a diagnosis of OA made?
Age 45+
Activity-related joint pain
PLUS
No morning joint-related stiffness or morning stiffness lasts no longer than 30 mins
What are red flag symptoms that suggest it is something more serious than OA?
Trauma
Prolonged morning-related stiffness
Rapid deterioration of symptoms
Hot, swollen joint
What are differential diagnoses for OA?
Gout
Other inflammatory arthritides
Septic arthritis
Malignancy
What is the investigation for OA?
XR
What is the first step in NICE guidelines for OA?
Holistic approach and self-management
What should you look at for a holistic approach of management for OA?
Social factors Knowledge of OA Occupation Mood Sleep quality Support network Other MSK pain Attitudes to exercise Influence of comorbidity Pain assessment
What is the second step in NICE guidelines for OA?
Core treatments: information, exercise and weight loss
What are additional treatments in the NICE guidelines for OA?
Non-pharmacological treatments
Pharmacological treatments
Referral for joint surgery
What are non-pharmacological treatments for OA?
Thermotherapy
Electrotherapy
Aids and devices
Manual therapy
What are pharmacological treatments for OA?
Oral analgesia: paracetamol/NSAIDs
Topical treatments: NSAIDs, capsaicin
Intra-articular injections: steroid
