Osteoarthritis/OA (1)

Question 1

What is it?

What is it due to?

What are its risk factors?

Answer 1

➊ Wear and Tear of joints over time

➋ Overuse, injury, and genetic - not inflammation

➌ • Obesity
• Age
• Female
• Family hx
• Occupation - overuse of certain joints
• Trauma

Question 2

How does it present?
→ Which joints does it tend to affect?

How is it differentiated from RA?

What may be found O/E of the hands?

Answer 2

➊ • Joint pain and stiffness
• Non-prolonged morning stiffness (< 20 mins)
→ Weight-bearing joints e.g. Hip, Knee

➋ Worse with movement, better with rest

➌ • Bouchard’s nodes (PIP)
• Heberden’s nodes (DIP)
• Squaring of thumb base

Question 3

How is it diagnosed?

Which signs will be seen on Knee XR?

Answer 3

➊ Clinically in those >45 yrs presenting with typical symptoms of joint pain + stiffness, worsened by activity w/o prolonged morning stiffness (< 20 mins)

➋ LOSS:
• Loss of joint space
• Osteophytes
• Subarticular sclerosis - increased bone density along joint line
• Subchondral cysts - fluid-filled holes in bone

Question 4

Management:
What are the conservative/lifestyle options?

What are the medical options?

What is the surgical option?
→ When would this be considered?

Answer 4

➊ Weight loss, Physiotherapy, Aerobic exercises (e.g. swimming)

➋ • Topical NSAIDs - pain ladder is used here
• Intra-articular steroid injections - effective, but temporary pain relief

➌ Joint replacement (Arthroplasty) - excellent pain relief, but won’t improve function
→ In severe cases, after exhausting other options