Osteoarthritis

Question 1

Management of OA

Answer 1

• Weight loss
• Local muscle strengthening exercises and general anaerobic fitness
• Paracetamol and TOPICAL NSAIDs are first-line analgesics
• Second line- oral NSAIDs/ COX-2 inhibitors, opioids, capsaicin cream and intra-auricular corticosteroids
• PPI should be co-prescribed with NSAIDs and COX-2 inhibitors

Question 2

Role of glucosamine

Answer 2

normal constituent of glycosaminoglycans in cartilage and synovial fluid
a systematic review of several double-blind RCTs of glucosamine in knee osteoarthritis reported significant short-term symptomatic benefits including significantly reduced joint space narrowing and improved pain scores

Question 3

Osteoarthritis: x-ray changes

Answer 3

decrease of joint space
subchondral sclerosis
subchondral cysts
osteophytes forming at joint margins

Question 4

Polyarthritis differentials

Answer 4

rheumatoid arthritis
SLE
seronegative spondyloarthropathies
Henoch-Schonlein purpura
sarcoidosis
tuberculosis
pseudogout
viral infection: EBV, HIV, hepatitis, mumps, rubella