OSTEOARTHRITIS Flashcards
What is the only cell found in hyaline cartilage? What happens to the cells in osteoarthritis?
Chondrocytes
when hyaline cartilage starts to break down the chondrocytes proliferate and attempt to repair by secreting proteases and cytokines. This repair is inadequate and they eventually die, exposing bone
Why is osteoarthritis referred to as non-inflammatory even though there is inflammation?
Low white blood cell count in synovial fluid
What are the 4 classic x-ray findings and osteoarthritis?
- Loss of joint space
- Osteophytes
- Subchondral sclerosis
- Subchondral cyst
Why is there subchondral sclerosis in osteoarthritis?
Hyaline cartilage breaks down → bone on bone rubbing → increased collagen with abnormal mineralisation of bone
The thickening of subchondral bone and joint margins cause which x-ray finding?
Osteophyte
How are subchondral cysts formed?
Bone cracks/contusion and is filled with synovial fluid
Which joint is often involved in osteoarthritis? Will it be one or both?
Both knees
Explain the asymmetry of the loss of joint space in this x-ray
There is more weight-bearing on medial side of knee and therefore narrowing is expected more on this side
What is this x-ray finding? What is it believed to be caused by?
Bouchard’s node
Believed to be caused by osteophytes
Which joints of the spine are often involved in osteoarthritis?
Facet joints - particularly cervical and lumbar spine
When do you expect the joint pain of osteoarthritis to worsen? What normally goes along with joint pain?
- Worsens after use of joint, at end of day and improves with rest
- Stiffness
- Restricted motion
What is main non-modifiable risk factor for osteoarthritis? What is main modifiable risk factor?
- Female gender and advanced age
- Obesity (esp knee, hands, hip)
What are the two main lifestyle modifications to improve osteoarthritis?
- Exercise, weight loss
What is the definitive treatment for osteoarthritis?
Surgery: knee and hip replacements
Acute onset monoarthritis must have which two causes excluded as an emergency?
- Septic arthritis
- Gout
Which haematological condition very commonly presents with joint pain in young patients? How can this be differentiated from osteoarthritis?
Haemochromatosis
→ Mostly involves MCP joints and accompanies high serum ferritin level
