Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

age-related degenerative joint disease when cartilage destruction exceeds repair, causing pain + disability

Question 2

How is osteoarthritis classified?

Answer 2

According to the distribution of affected joints

Question 3

What is the pathogenesis of osteoarthritis ?

Answer 3

Synovial joint cartilage destruction
Eventually, there is loss of joint volume due to altered chondrocyte activity
Patchy chronic synovial inflammation
Fibrotic thickening of joint capsules

Question 4

Describe the aetiology of primary osteoarthritis

Answer 4

UNKNOWN aetiology

Multifactorial causes

Question 5

Describe the aetiology of secondary osteoarthritis

Answer 5

Other diseases lead to altered joint architecture + stability

Question 6

List 4 commonly associated diseases of osteoarthritis

Answer 6

Developmental abnormalities (e.g. hip dysplasia)
Trauma (e.g. previous fractures)
Inflammatory (e.g. RA, gout, septic arthritis)
Metabolic (e.g. haemochromatosis, acromegaly)

Question 7

Describe the epidemiology of osteoarthritis

Answer 7

COMMON
25% of those > 60 yrs
More common in FEMALES, CAUCASIANS and ASIANS

Question 8

Describe the pain experienced in osteoarthritis

Answer 8

Use-related  
Stiffness or gelling after inactivity  
Difficulty with certain movements  
Feelings of instability  
Restriction walking, climbing stairs + doing manual tasks 
Systemic features are usually absent

Question 9

List 5 signs of osteoarthritis

Answer 9

Local joint tenderness  
Bony swellings along joint margins  
Crepitus + pain during joint movement  
Joint effusion  
Restriction of range of joint movement

Question 10

What bony swellings are found along joint margins in osteoarthritis?

Answer 10

Heberden’s Nodes: DISTAL interphalangeal joint

Bouchard’s Nodes: PROXIMAL interphalangeal joint

Question 11

What is seen on x ray of the affected joint in osteoarthritis?

Answer 11

Loss of joint space (narrowing)
Osteophytes
Subchondral cysts
Subchondral sclerosis