Osteoarthritis

Question 1

What is the pathophysiology of osteoarthritis?

Answer 1

Breakdown of joint cartilage and underlying bone

Question 2

What ae the risk factors for osteoarthritis?

Answer 2

>50
Female
FH
Obesity 
Manual/physical occupation

Question 3

What is the presentation of osteoarthritis?

Answer 3

Pain following use, improves with rest
Often unilateral 
Functional difficulties
Limited ROM
Stiffness, worse with use
Deformity- e.g. Herberden's nodes

Question 4

What joints are classically involved in OA?

Answer 4

Large or weight bearing joints

Knee, hip, spine and hand involvement

Question 5

Hw is OA diagnosed?

Answer 5

Clinically

XR

Question 6

What is the XR appearance in OA?W

Answer 6

Loss of joint space
Osteophytes
Subchondral cysts - increased bone formation around joint
Subchondral sclerosis

Question 7

What are the principles of management of OA?

Answer 7

Information, exercise and weight loss
Non pharm
Pharm
Surgical

Question 8

What are the non pharm treatments of OA?

Answer 8

Thermotherapy
Electrotherapy
Aids and devices
Manual therapy e.g. physio

Question 9

What are the pharm treatments of OA?

Answer 9

Oral analgesia- Paracetamol, NSAIDs, opiates
Topical- NSAIDs, capsaicin
Intraarticular steroid injection

Question 10

What are the indications for surgical referral?

Answer 10

Substantial impact on QOL

Refractory to non surgical treatment