Osteoarthritis Flashcards
What is OA
A chronic disease characterised by cartliage loss and periarticular change
What are the most commonly affected joints
Knees, hands and hips
What are some risk factors
Ageing, female sex, obsesity, occupational usage
Why are females more commonly affected
As they are more likely to develop osteoporosis
What are all the features of an osteoarthritic joint
Subchondral bone cyst, thickened joint capsule, episodic synovitis, fibrillated cartilage, osteophyte, degenerative cartilage loss and subchondral bone sclerosis
What is generalised OA
OA at either spinal or hand joints and in at least 2 other joint regions
What are Heberden’s nodes
osteophytes/ bone swelling at DIP joints in hand
What are Bouchard’s nodes
osteophytes/ bone swelling in PIP joints in hand
What is a CMC joint
squaring of thumb, closer to palm than what it should be (associated with poor grip) 1st CMC and trapezoscaphoid
What is the presentation in thumb OA
Poor grip
What has morning stiffness got to do with OA
Lasting less than 30 minutes
How does joint pain change with use
Pain is worse with use
What are the examination features
joint line tenderness, crepitus, bony swelling (osteophyte), deformity (valgus/varus in knee) and limitation of motion
What is also seen in the knee OA
Baker’s cyst
Where is pain from hip OA felt
felt in groin, or radiating to knee or lower back
What is the pain associated with cervical spine OA
Occipital headaches are common. Pain and restriction of movement. osteophytes may impinge on nerve roots
What is the pain associated with lumbar spine OA
osteophytes can cause spinal stenosis if they encroach on the spinal canal.
How is diagnosis done in OA
Clinical based on signs and symptoms
What is seen on Xray
Marginal osteophytes.
Joint space narrowing.
Subchondral sclerosis.
Subchondral cysts
What are the pitfalls of Xray in OA
insensitive especially in early disease, and correlate poorly with disease activity
What is the surgical management in OA
Joint replacements mainly.
What is the medical management of OA
Analgesia, rarely steroid injections, physio, OT, education (exercise is important to strengthen muscles around joints!!)
What joint has the worst prognosis
Hips
What is the natural history of knee OA
third improve, third stable and third deteriorate
