Osteoarthritis

Question 1

P

Where

Answer 1

Cartilage damage
Loss of join space
Pain, functional limitation

Hip 
Knee
Lumbar
Cervical spine
Wrist

Question 2

A

Answer 2

Older age
Female - post-menopausal
FHx
Paget’s disease (increased bone density)

Obesity
Injury
Joint damage
Occupation - cleaners, hairdressers, farmers - hip

Question 3

S

Answer 3

Pain
Worse with prolonged actifivity
Stiffness
Instability

Periarticular tenderness
Crepitus
Reduced range of motion
Joint deformity
Bouchard's nodes (PIPJ)
Herberden's nodes (DIPJ)
Synovitis and effusion

Question 4

I

Answer 4

X-ray
LOSS
Loss of joint space
Osteophyte formation
Subchondral cysts
Subarticular sclerosis

RF and Anti-CCP negative

Question 5

M

Answer 5

ELMS:
Exercise
Weight loss
Physiotherapy
Aids and devices - orthotics, bracing
TENS

Analgesia:
Paracetamol/topical NSAIDs/topical capsaicin
Weak opioid
Oral NSAID + PPI
Intra articular steroids injections

Surgery:
Joint replacement