Osteoarthritis

Question 1

Does running cause osteoarthritis?

Answer 1

non conclusive in studies; but best modifying activity is weight loss

Question 2

Best treatment modality

Answer 2

physical therapy

Question 3

Treatment for pain long term associated with osteoarthritis

Answer 3

duloxetine

Question 4

are there therapies to cure or reverse osteoarthritis?

Answer 4

no only meant ot help slow progression or control symptoms by activit yand lifestyle management

can use medical or surgical therapy.

Question 5

What conditions can predispose someone to osteoarthritis?

Answer 5

hip dysplasia, Legg Calve Perthe dx and slipped capital femoral epiphysis as a child.

avascular necrosis

diabetes, gout, and RA can lead to osteoarthritis.

Question 6

What is seen on XR with knee osteoarthritis?

Answer 6

subchondrial sclerosis, osteophyte formation, cyst formation, thinned cartilage and joint space narrowing.

Question 7

Diagnosis of hip osteoarthritis

Answer 7

ESR<20 and weight bearing AP pelvix XR shows osteophytes (femoral or acetabular) or joint space narrowing (superior, axial, or medial).

Tx with rest and NSAIDs

Question 8

when does hip OA start and what is seen on physical exam?

Answer 8

starts after age 50 with groin pain. see impaired internal rotation and hip flexion.

can have pain radiate down to knee but no further.

Question 9

treatment of hip OA

Answer 9

weight loss, wedged shoe insoles are recommended first and effective in some patients

if doesn’t work NSAIDS and can try intraarticular steroid injections followed by intraarticular hyaluronic acid or short term steroids in refractory pts.

Surgery should be done early before the patient develops significant deformities, joint instability, contractures, or muscle atrophy

Question 10

XR findings in osteoarthritis (LOSS)

Answer 10

loss of joint space
osteophytes
subchondrial sclerosis
subcondral cysts

LOSS

won’t see lateral compartment height loss on XR Of knee = that is seen with mensical injury.

Question 11

Joint fluid analysis of osteoarthritis:

Answer 11

non inflammatory process with total cell count <2000 WBCs.

Question 12

characteristic symptoms of osteoarthritis

Answer 12

morning stiffness <30 minutes, pain worsens with activity, boney enlargement and tenderness and no palpable warmth.

Question 13

Secondary causes of osteoarthritis are:

Answer 13

trauma, underlying inflammatory arthritis, infection, calcium pyrophosphate deposition disease, metabolic disorders (hemochromatosis)

Question 14

primary osteoarthritis of the hands involve generally the:

Answer 14

proximal and distal interphalangal joints and first MCP joint.

Question 15

hamstring injury pain is located.

Answer 15

would be felt over the buttock area and may extend to the trochanteric bursa area.