Osteoarthritis Flashcards
Give possible radiographic features of OA
Sclerosis Chondrocalcinosis Loss of joint space Periarticular erosions Cyst
Give some metabolic causes of OA
Alkaptonuria
Acromegaly
What is alkaptonuria
Disorder in the break down of amino acids, leading to dark urine that turns black when exposed to air
Give some other causes of OA
Bone diseases e.g. Paget’s disease
Trauma
Give some neuropathic causes of OA
DM
Syphilis
Give some inflammatory causes of OA
RA
Gout
Infections
Give some haematological causes of oA
Haemophilia
Sickle cell disease
Management of OA first line
Patient education
Referral to OT and physio
Social support
Weight loss
Which drugs might be prescribed in OA?
Paracetamol
NSAIDS ARE NOT USED AS INEFFECTIVE
Capsaicin
How does capsaicin work?
Depletes substance P, a neurotransmitter between peripheral and central nervous system
Sings of osteoarthritis
Bouchard’s nodes of PIP
Joints affected
1st CMCPJ (base of thumb) DIP & PIP Hip Knee Shoulder Spine
Predisposing factors
Age Female Obesity Genetics Joint injury/damage
What worsens the pain?
Activity related
What improves the pain?
Rest
How long is the morning stiffness for?
<30mins
What would you see on examination?
Boney swelling Joint deformity Joint instability (giving way) Joint warmth + tenderness Muscle wasting/weakness Restricted and painful range of movement Crepitus
Differentiate between herbeden and bouchard nodes
HerberDen = distal
Bouchard = PIP
Which nodes are seen?
Herbeden and bouchard nodes
Investigations
If someone is over 45 years, has typical symptoms then you can clinically diagnose it
What might be seen on XR
Subchondral bone thickening
Cysts
Narrowing of joint space
Management
Education Self-care Analgesia Intra-articular corticosteroid injections Physiotherapy OT Podiatry Surgery Pain clinic
