osteoarthritis Flashcards
what is osteoarthiritis?
This is the commonest type of arthritis
a degenerative joint disorder in which there is progressive loss of articular cartilage accompanied by new bone formation and capsular fibrosis.
what is the aetiology of OA?
3 possible scenarios
- Failure of normal cartilage subject to abnormal or
incongruous loading for long periods - Damaged or defective cartilage failing under
normal conditions of loading - Break up of cartilage due to defective stiffened subchondral bone passing more load onto it
what are the key features of cartilage in OA?
loss of elasticity with a reduced tensile strength
cellularity and proteoglycan content are reduced
what are the risk factors for OA?
- > 65
- women are more symptomatic than men
- obesity
- trauma
- joint malalignment
- FH
what parts of the body are most affected by OA?
hip, knee and spine
what are the signs and symptoms of OA?
pain is provoked by movement and by weight bearing
can also get crepitus on movement, with background ache at rest
stiffness after rest
at first its intermittent, but later may be constant
may observe nodal OA
what are the x ray features of OA?
- joint space narrowing
- subarticular sclerosis
- bone cysts
- ostephytes
what non drug therapy can be used for OA?
local can be improved with a range of movement exercises and physiotherapy
loading of joint can be reduced by weight loss and use of laterally wedged insoles or a walking stick
what pharmacological therapies can be used for OA?
paracetamol
NSAIDs in short term
can use topical NSAIDs
intra-articular corticosteroids can be offered
what surgeries can be used for OA?
joint replacements can be offered if pharmacological and physical modalities are insufficient
where does nodal OA occur?
affects the PIPJ (Bouchard’s nodes) and the DIPJs (Herbedens)
