Osteoarthritis and principles of management Flashcards
1
Q
What members of MDT manage osteoarthritis?
A
- Nurses
- Physicians
- GPs
- Dietitians
- OTs
- Physiotherapists
- Ortho surgeons
2
Q
In basic terms what happens in osteoarthritis?
A
- Trauma and mechanical imbalance
- Inflammation and pain
- Repair processes around joint
3
Q
What are some biomechanical factors behind osteoarthritis?
A
- Abnormal anatomy
- Intra-articular fracture
- Ligament rupture
- Meniscal injury
- Occupation - farmers, footballers
- Persistent heavy physical activity
- Elite running
- Obesity
4
Q
What is associated with inflammation in OA?
A
- Synovial hypertrophy
- Subchondral changes
- Joint effusion
5
Q
Could biochemical mediators be part of OA?
A
Possibly. Markers like interleukins, TNFs etc could be significant
6
Q
How do you diagnose OA?
A
- 45y+
- Activity related joint pain PLUS has either no morning joint related stiffness or morning stiffness lasting no longer than 30min
7
Q
What are some alarming symptoms?
A
- Trauma
- Prolonged morning-related stiffness
- Rapid deterioration of symptoms
- Hot, swollen joint
8
Q
What is the differential diagnosis of OA?
A
- Gout
- Septic arthritis
- Inflammatory arthritides
- Malignancy
9
Q
What are non-pharmacological treatments of OA?
A
- Thermotherapy
- Electrotherapy
- Aids and devices
- Manual therapy
10
Q
What are pharmacological treatments of OA?
A
- Paracetamol, NSAIDs (oral)
- NSAIDS, capsaicin (topical)
11
Q
When should OA patients be referred for joint replacement surgery?
A
- Substantial impact on QoL
- Refractory to non-surgical treatment
- Referral letter
