Osteoarthritis, Crystal Arthritis and Soft tissue rheumatism Flashcards

1
Q

what does osteoarthritis look like on x-ray

A

no cartilage

bones are tight together

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2
Q

what is osteoarthritis

A

articular cartilage thinning or loss

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3
Q

risk factors for osteoarthritis

A
age 
female 
obestity 
previous injury 
muscle weakness 
proprioceptive deficits 
genetic elements 
acromegaly 
joint inflammation 
crystal deposition in cartilage
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4
Q

what causes secondary osteoarthritis

A

previous injury
calcium crystal deposition
rheumatoid arthritis

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5
Q

what are the two types of osteoarthritis

A

idiopathic

secondary

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6
Q

symptoms of osteoarthritis

A

pain- typically worse on activity and relieved by rest

stiffness - early morning lasting less than 30 mins

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7
Q

clinical presentation of osteoarthritis

A

crepitus
joint swelling - bony enlargements due to osteophytes
joint tenderness
joint effusion

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8
Q

clinical features in the hands

A

DIP, PIP and 1st CMC joints
body enlargements may be seen at DIP
squaring of the hand

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9
Q

clinical features in the knee

A
osteophytes
effusions 
crepitus and restriction of movement 
genu varies and values 
bakers cyst
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10
Q

clinical features in the hip

A

pain felt in groin or radiating to knee
pain felt in hip may be radiating from lower back
hip movements restricted

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11
Q

clinical features in the spine

A

cervical pain and restriction of neck movement

lumbar - pain on standing or walking for some time

osteophytes can cause spinal stenosis if encroach on spinal canal or pinch the nerve route

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12
Q

radiological features of osteoarthritis

A

loss of joint space
subchondral sclerosis
subchondral cysts
osteophytes

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13
Q

what is the kellgren Lawrence scare

A

radiographic grading scale of osteoarthritis

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14
Q

what is grade 0

A

no radiographic findings of osteoarthritis

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15
Q

grade 1

A

minute oestophytes of doubtful clinical significance

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16
Q

grade 2

A

definite osteophytes with unimpaired joint space

17
Q

grade 3

A

definite osteophytes with moderate joint narrowing

18
Q

grade 4

A

definite osteophytes with severe joint space narrowing and subchondral sclerosis

19
Q

non-pharmacologic treatments

A

physiotherapy -muscle strengthening
proprioceptive
common sense measures (weight loss, exercise, trainers, walking stick)

20
Q

pharmacological treatments

A

analgesia
NSAIDS
Pain modulators
Intra articular steroids

21
Q

surgical management

A

arthroscopic washout, loose body, soft tissue trimming

joint replacement

22
Q

what is gout

A

inflammation in the joint triggered by uric acid crystals

23
Q

what is hyperuriceamia

A

uric acid >0/42mmol/l

24
Q

what causes hyperuriceamia

A

increased rate production

reduced urate excretion

25
Q

what causes increased urate production

A
inherited enzyme defects 
psoriasis 
haemolytic disorders 
alcohol 
high dietary purine intake (red meat, seafood, corn syrup)
26
Q

what causes reduced urate excretion

A
chronic renal impairment 
volume depletion eg. heart failure 
hypothyroidism 
diuretics 
cytotoxics
27
Q

describe acute gout

A

monoarthopathy
settles in abut 10 days without treatment
settles in 3 days with treatment
abrupt onset, often overnight
may have normal uric acid during acute attack