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MSK > Osteoarthritis and principles of management > Flashcards

Osteoarthritis and principles of management Flashcards

1
Q

How does osteoarthritis occur?

A 
Abnormal anatomy such as ligament/muscle damage/weakness
Instability
Increased load
Joint microtrauma
Osteoarthritic joint
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2
Q

What are the biomechanical factors affecting/causing osteoarthritis?

A 
Abnormal anatomy
Intra-articular fracture
Ligament rupture
Meniscal injury
Occupation (heavy lifting, repeated trauma)
Obesity
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3
Q

What are some features of inflammation in OA?

A

Synovial hypertrophy
Bone thickens below articular cartilage
Joint effusion

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4
Q

How do you diagnose osteoarthritis?

A

Aged 45+ unless predisposing trauma
Activity related joint pain
Morning joint stiffness no longer 30 mins

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5
Q

Are hot swollen joints associated with osteoarthritis?

A

Not usually

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6
Q

What are some differential diagnoses to keep in mind?

A

Gout (especially knee)
Septic arthritis
Malignancy

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7
Q

Which condition must be ruled out when a patient presents with sudden onset, painful, swollen, immobile joint?

A

Septic arthritis

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8
Q

How is imaging involved in diagnosis?

A

X-ray may confirm clinical diagnosis

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9
Q

What are some factors when considering management options?

A 
ADLs
Family duties
Hobbies
Occupation
Quality of life
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10
Q

What are some non-pharmacological treatments for OA?

A

Thermotherapy
Electrotherapy
Manual therapy
Aids and devices like splints or walking sticks

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11
Q

What are some therapies NICE do not recommend for OA?

A

Acupuncture

Nutraceuticals like glucosamine or chondroitin

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12
Q

What are some self help strategies encouraged for OA?

A

Exercise
Muscle strengthening
Weight loss

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13
Q

What are the 3 main parts to pharmacological treatment of OA?

A

Oral analgesia
Topical treatments
Intra-articular injections

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14
Q

What are some oral analgesia used for OA?

A

Paracetamol

NSAIDs

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15
Q

What are some possible topical treatments for OA?

A

NSAIDs

Capsaicin (knee, hand)

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16
Q

What is used for intra-articular injections to treat OA?

A

Steroid

Hyaluronic acid

17
Q

When are patients referred for surgery?

A

Substantial impact on quality of life

Refractory impact to all non-surgical treatment

18
Q

What are some x-ray features for OA?

A 
Sclerosis
Cysts
Narrowing of joint space
Osteophytes
Head of femur migrating towards hip

MSK (26 decks)

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