Osteoarthritis/Degenerative Joint Disease

Question 0

Synovitis?

Answer 0

Inflammation of the joint space characterized by redness, swelling, and tenderness

Question 1

Osteoarthritis – commonly seen effects on the hand joints?

Answer 1

Bouchard nodes – PIP

Heberden nodes – DIP

Question 2

Gel phenomena?

Answer 2

15 to 30 minutes of joint stiffness after inactivity (usually in the morning)

In contrast, in rheumatoid arthritis, morning stiffness lasts 1 to 2 hours

Question 3

Joint fluid aspiration of a patient with osteoarthritis would show?

Answer 3

Lack of inflammation: WBC < 45, glucose equal to serum

Question 4

Joints affected in OA?

Joints spared?

Answer 4

DIP, PIP, CMP of thumb, knee, hip, feet

Wrist, elbow, shoulder, spine

Question 5

Most specific finding of osteoarthritis? Other x-ray findings?

Answer 5

Osteophytes. Joint space narrowing, subchondral sclerosis, subchondral cysts

Question 6

Periarticular pain that is not reproduced with passive movement suggests?

Prolonged pain that lasts for more than one hours suggests?

Joint pain with systemic constitutional symptoms suggests?

Answer 6

Bursitis or tendinitis

Inflammatory arthritis

Inflammatory condition (polymyalgia rheumatica, RA, SLE, malignancy)

Question 7

Non-medical Management of osteoarthritis?

Answer 7

1. Stay active – not using joint causes further immobility
2. Short periods of rest >1 large period of rest
3. Apply heat to affected joint

Question 8

Medical management osteoarthritis?

Answer 8

NSAIDs – anphetamine first choice. Can use COX-2 inhibitors in patients without cerebrovascular disease

Intra-articular steroids helpful for rare inflammation of “locked up” joint