Osteoarthritis

Question 1

classification

Answer 1

can be primary or secondary

Question 2

1) Primary

Answer 2

• Cause unknown
• Risk factors
  
  • Age
  • Sex
  • Ethnicity
  • Nutrition
  • Genetics

Question 3

2) Secondary

Answer 3

• Obesity
• Trauma (sports and occupational risk factors
• Malalignment e.g. developmental dysplasia
• Infection
• Inflammatory arthritis e.g. rheumatoid arthritis
• Metabolic disorders affecting the joint e.g. gout
• Haematological disorders e.g. haemophilia with bleeding in the joint
• Endocrine abnormalities e.g. diabetes mellitus with neurovascular impairment

Question 4

Symptoms of osteoarthritis of the hip

Answer 4

• Joint stiffness after getting out of bed or sitting for a long time
• Pain, swelling or tenderness in hip joint
• Crepitus- sound or feeling (crunchy) of bone rubbing against bone
• Reduced ability to move the hip to perform routine activities

Question 5

Pathology of osteoarthritis

Answer 5

• Precipitating risk factors (e.g. obesity, trauma) lead to excessive loading of joint and damage to articular cartilage
• Increased proteoglycan synthesis by chondrocytes
  
  • Initial attempt to repair cartilage damage
• Flaking and fibrillation of articular cartilage
• Erosion of cartilage down to subchondral bone (below cartilage)
  
  • Reduced joint space on X-ray

Question 6

Altered joint biomechanics leads to:

Answer 6

• Vascular invasion and increased cellularity of subchondral bone (subchondral sclerosis (stiffing of tissue)
• Cystic degeneration if bone
• Osseous metaplasia of connective tissue (osteophytes)

Question 7

Radiological features of osteoarthritis

Answer 7

1. Reduced joint space
2. Cysts noted in bone of femur head
3. Sclerosis of bone
4. Loss of joint space

Question 8

OA hip is diagnosed on

Answer 8

clinical presentation (symptoms and signs) supported by radiography (X-rays)

Question 9

treatment: non-operative

Answer 9

• Activity modification
• Weight loss
• Stick/walker
• Physiotherapy
• Medication
  
  • NSAIDs (naproxen, ibuprofen)
  • CO-2 inhibitors (celecoxib)
  • Nutritional supplement (glucosamine)
• Injections
  
  • Corticosteroid
  • Viscosupplementation (artificial synovial fluid)

Question 10

Viscosupplementation

Answer 10

(artificial synovial fluid)

Question 11

surgical procedure

Answer 11

repalcement of joint

• reduce pain
• improved well being of patinet