Osteoarthritis and spondylarhtorpathies Flashcards
What is osteoarthritis
Disease of synovial joints where articular cartilage loss leads to accompanying periarticular bone response
Bones rubbing together affects muscle
Describe the four stages of disease progression that occur in osteoarthritis
- Initial Repair
Proliferation of chondrocytes that synthesise extracellular matrix of bone - Early Stage Osteoarthritis
Degradation of extracellular matrix that exceeds chondrocyte activity resulting in net breakdown and loss of articular cartilage at joint - Immediate Stage Osteoarthritis
Failure of extracellular matrix synthesis and increased break down of cartilage
4. Late stage osteoarthritis Extreme or complete loss of cartilage with joint space narrowing Bony Outgrowths appear at joint margins General bone sclerosis Pain and reduced joint movement
What are the risk factors of osteoarthritis
Increasing age
Gender
Less than 45 = men
55-70= women
Knee osteoarthritis= women
Race
Hip osteoarthritis less common in chinese, afro-carribean compared to europeans
Obesity- BIG FACTOR
Physical and occupational factors
Trauma
What are the symptoms of osteoarthritis
Joint pain in weight bearing joints (hip, knee, spine)
Pain- worse with movement
Morning stiffness joint, lasts for less than 30 minutes
Synovial thickening
Deformity of joint
Bone swellings
Limited Joint Movement
Joint effusion
Muscle weakening or wasting
Crepitus- cracking or popping of joint
How do you diagnose osteoarthritis
Clinical presentation (location of affected joint, pain on movement not at rest, gets worse throughout day)
X ray:
Narrowing of joint space
Bony protrusions
Bony sclerosis
Arthroscopy
Yellowing
Irregular
Ulcerated- cartilage often present
What are the treatment goals for osteoarthritis
Reduction of pain due to damage to bone and cartilage
Increased mobility
Reduced disability
Minimal disease progression
what are the non drug treatment options of osteoarthritis (4)
Exercise- builds up muscle strength and improve range of joint movement
Weight loss- helps protect against weight bearing joints
Physical therapy- heat, cold, ultrasound, TENS machine
Education- chronic but not progressive
Alleviate psychological factors
What available complementary therapies are there for osteoarthritis
Nutraceuticals- glucosamine and chondroitin
Acupuncture
Magnets and copper braces
What are the treatment options available for management of osteoarthritis
Paracetamol (FIRST CHOICE)
Topical NSAIDS
Intra-articular corticosteroid Injections- benefit of reduced pain and increased mobility from soft tissue inflammation
Intra-articular injection of hyaluronic acid derivatives- into synovial fluid and returns its elasticity and viscosity
Rubefacients- counter irritants
Surgery- if physical and drug treatment fail
What are rubefacients able to cause and give an example of them
Redness
Dilation of capillaries
Increase of blood flow to area
Example:
Capsaicin (0.025%) for symptomatic relief
Spondylarthropathies a general term for inflammatory rheumatic diseases such as…
Ankylosing Spondylitis
Psoriatic or reactive arthritis
Enteropathic Arthritis- associated with inflammatory bowel disease
What is ankylosing spondylitis
Condition that causes inflammation of sacroiliac joint that makes up the spine leading to symptoms
What are the symptoms present in ankylosing spondylitis
Morning back stiffness and pain for more than 30 minutes
Pain- better with exercise not rest
What can ankylosing spondylitis lead to
Spinal fusion (ankylosis)
Decrease in spinal movement
Leads to spinal kyphosis
Sacroiliac joint fusion
Neck hyperextension and rotation
How do you diagnose ankylosing spondylitis
X ray
Has to have criterion of Sarcoilitis
Or Clinical Criterion:
Low back pain and stiffness- improves with exercise for 3 months
Limitation of motion of lumbar spine in sagitall and frontal plans
Limitation of chest expansion for age and sex
Excludes: spinal fracture, disc disease, fibromyalgia
