Osteoarthritis Flashcards
Define:
Age related degenerative joint disease when cartilage destruction exceeds repair leading to pain and disability
Aetiology:
IRREVERSIBLE ARTICULAR CARTILAGE LOSS.
Due to natural ware and tear (age is the greatest RF)
Chondrocytes will increase the destruction
What are the commonly affected joints:
DIP
Knees
Thumb
Carpo-metocarpal
What are the causes of primary:
o UNKNOWN aetiology
o Multifactorial causes
What are the causes of secondary:
o Other diseases lead to altered joint architecture and stability
o Commonly associated diseases include:
Developmental abnormalities (e.g. hip dysplasia)
Trauma (e.g. previous fractures)
Inflammatory (e.g. rheumatoid arthritis, gout, septic arthritis)
Metabolic (e.g. haemochromatosis, acromegaly)
Obesity
Occupational
Risk factors:
AGE obesity Inflammation Joint injury Mechanical stress Nero disorders Genetics Medication
Epidemiology:
Common
25% of over 60s
more in females, caucasians and asians
Symptoms:
• Joint pain and discomfort – usually localised to knee or hip
o Use-related
o Pain on movement and crepitus
o Worse at end of day and in the mornings u
o Background pain at rest
• Stiffness or gelling after inactivity lasting < 1 hour
• Difficulty with certain movements
• Feelings of joint instability
• Restriction walking, climbing stairs and doing manual tasks
• Systemic features are usually absent
Signs:
• Local joint tenderness
• Bony swellings along joint margins
o Heberden’s Nodes - DISTAL interphalangeal joint
o Bouchard’s Nodes - PROXIMAL interphalangeal joint
• Crepitus and pain during joint movement
• Joint effusion
• Restriction of range of joint movement
Investigations:
Joint X-ray will show LOSS
Loss of joint space (joint space narrowing)
Osteophytes
Subchondral cysts – fluid-filled sac that forms in joint space
Subarticular sclerosis
CRP may be slightly raised
