Osteoarthritis and Principles of Management

Question 1

Osteoarthritis

Answer 1

• a degenerative joint disorder

- most commonly affected joints are the knee, hip, hands and lumbar and cervical spine

Question 2

Biochemical factors affecting osteoarthritis

Answer 2

• Abnormal anatomy (DDH)
• Intra-articular fracture
• Ligament rupture
• Meniscal injury
• Occupation – farmers, football players
• Persistent heavy physical activity
• Elite running
• Obesity

Question 3

Osteoarthritis symptoms

Answer 3

• pain
• functional difficulties
• bone deformities
• limited range of movement
• malalignment

Question 4

Osteoarthritis investigations

Answer 4

• X-ray of affected joints
• serum CRP
• serum ESR
• rheumatoid factor (RF)

Question 5

Osteoarthritis non-pharmacological treatment

Answer 5

• Thermotherapy
• Electrotherapy
• Aids and devices
• Manual therapy

Question 6

Pharmacological treatments

Answer 6

• Oral analgesia: paracetamol, NSAIDs
• Topical treatments: NSAIDs, capsaicin (knee, hand)
• Intra-articular injections: steroid, (hyaluronic acid)

Question 7

Osteoarthritis when to refer to surgery

Answer 7

• Substantial impact on quality of life

- Refractory to non-surgical treatment