Osteoarthritis and principles of management Flashcards
How is osteoarthritis defined by arthritis research uk?
Tear, flare, and repair
What happens to joints in osteoarthritis?
Trauma and mechanical imbalance
Inflammation and pain
Repair processes around the joint
What are biomechanical factors in osteoarthritis?
Abnormal anatomy Intra-articular fracture Ligament rupture Meniscal injury Occupation - farmers, football players Persistent heavy physical activity Elite running Obesity
What happens as a result of inflammation?
Synovial hypertrophy
Subchondral changes
Joint effusion
What is the pathogenesis of osteoarthritis?
Muscle weakness/ligament injury/abnormal anatomy leads to instability/malalignment
Obesity and/or instability leads to increased load
Increased load leads to joint microtrauma
Joint microtrauma leads to osteoarthritic joint
How is osteoarthritis diagnosed?
45 years +
Activity related joint pain
Has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes
What are differentials for osteoarthritis?
Gout
Other inflammatory arthritides
Septic arthritis
Malignancy
How is osteoarthritis investigated?
X-ray to confirm diagnosis
How is osteoarthritis managed in primary care?
Hollistic approach and self-management
What are non-pharmacological treatments for osteoarthritis?
Thermotherapy
Electrotherapy
Aids and devices
Manual therapy
What are pharmacological treatment options for osteoarthritis?
Oral analgesia - paracetamol, NSAIDs
Topical treatments - NSAIDS, capsaicin
Intra-articular injections - steroid
What is involved in the hollistic approach for osteoarthritis?
Social Health beliefs Occupational - adjustments to home or workplace Mood Quality of sleep Support network Other MSK pain Attitudes to exercise Influence of comorbidity Pain assessment
When should someone with osteoarthritis be referred for surgery?
Substantial impact on quality of life
Refractory to non-surgical treatment
