Osteoarthritis Flashcards
what kind of disease is osteoarthritis
a degenerative joint disease, the most common type of joint disease
describe the primary causes of osteoarthritis
insidious, no overt cause, age related
describe the secondary/predisposing causes of osteoarthritis
excess/inappropriate weight bearing(obesity), female, injury, systemic conditions, genetic factors
what joints does osteoarthritis usually affect
hips, knees, lower lumbar and cervical vertebrae, PIP and DIP joints in fingers
(wrists, shoulder and elbows usually spared)
what is felt at the joints in osteoarthritis
aches and pains that are worse with use
describe the initial pathology in osteoarthritis
degeneration of the cartilage and disordered repair
what pathological changes are seen in early osteoarthritis
damage to cartilage, clusters of chondrocytes, small fissures in cartilage, fibrillation
describe the secondary pathology of ostearthrits
stimulation of inflammatory changes in synovium and subchondral bone, repetitive injury and chronic inflammation
what pathological changes are seen in later stages of osteoarthritis
subchondral cysts, surface becomes polished(‘eburnation’), remodelling, formation of osteophytes
describe what happens to the cartilage in the later stages of osteoarthritis
cartilage is completely worn away, bone to bone
describe what an osteophyte is
a bone growth/projection formed at the margins of joints caused by stress and damage to surface
describe what eburnation is
degenerative process at joint where friction causes reactive conversion of sub-chondral bone to an ivory-like surface at site of erosion
describe the prevention of osteoarthritis
no specific means to prevent it, and once started little to prevent disease progression
what different types of osteoarthritis are there(OA)
localised or generalised
define generalised OA
OA at either spinal or hand joints and at least 2 other sites
describe what Heberden’s and Bouchard’s nodes are
Heberden's = osteophytes at DIP joints of fingers Bouchard's = osteophytes at PIP joints of fingers
how does OA in the CMC joint of the hand present
as squaring of the thumb, thumb closer to hand than it should be
describe the clinical presentations of OA
morning stiffness(<30mins), pain worse with joint use, instability, poor grip with thumb
what is seen on examination of OA
joint line tenderness, crepitus, bony swelling, deformity, limitation of movement(esp. hip)
what clinical features are seen in OA of the knee
effusions, crepitus, genu varus, valgus deformities, Baker’s cysts
where may pain from hip OA be felt
in groin, or radiate to knee or be felt in lower back
what may be seen in OA of the cervical spine
pain, restriction of movement, occipital headaches
what may be seen in OA of lumbar spine
osteophytes can cause spinal stenosis
what investigations can be used for OA
plain X-ray, MRI, ultrasound scan
how is OA mainly diagnosed
usually a clinical diagnosis as imaging may not correlate with symptoms
what may be seen on X-ray in OA
marginal osteophytes, joint space narrowing, subchondral sclerosis, subchondral cysts
what is involved in the non-pharmacological treatment of OA
patient education, lifestyle management, physiotherapy, occupational therpay
what is involved in the pharmacological treatment
NSAIDs, analgesia and local intra-articular steroid injections
what surgical treatments can be used in OA
joint replacement or arthroscopic surgery to remove loose bodies etc.
