Osteoarthritis and management

Question 1

what is osteoarthritis

Answer 1

this is a chronic disease of synovial joints in which some form of trauma activates and flares up the condition causing pain and swelling gin the synovial joints

Question 2

what are the main differences between OA and RA

Answer 2

OA occurs anywhere and RA is usually concentrated in the DIP joints
OA has less stiffness/no stiffness and RA has at least 30 mins of stiffness in the morning
OA is characterised by worse pain in the evening and RA is associated with more pain in the morning

Question 3

what are the risk factors for developing OA

Answer 3

• abnormal joint anatomy
• ligament rupture
• obesity
• occupation (e.g. footballers)
• elite runners
• intra-articular fracture
• meniscal injury

Question 4

what factors are needed to diagnose OA

Answer 4

• age >45
• activity related joint pain
• no morning or limited stiffness

Question 5

what is the Dx of OA

Answer 5

• gout
• malignancy
• other inflammatory arthrides
• septic arthritis

Question 6

name some non-pharmacological treatments for OA

Answer 6

• thermotherapy
• electrotherapy
• aids and devices
• encourage exercise and weight loss

Question 7

name some pharmacological managements of OA

Answer 7

• oral analgesia

- topical treatments (NSAID cream)

Question 8

when should you refer someone with OA for surgery

Answer 8

when all other treatment options have been exhausted or when it is having a substantial impact impact on the patients life

Question 9

what are the signs and symptoms of OA

Answer 9

• pain and stiffness of the joint
• swelling of the joint
• crepitus
• Heberden’s nodes (at the DIP joints)
• Bouchard’s nodes (at the PIP joints)

Question 10

what investigations should you carry out in OA

Answer 10

• bloods - useful for identifying if the OA is linked to any other conditions (e.g. haemachromatosis)
• imaging - look for signs of LOSS
  L = loss of joint space
  O = osteophytes
  S = sclerosis
  S = subchondral cysts