Osteoarthritis - Postlethwaite/Gupta Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Osteoarthritis (OA) definition?

A

Progressive degeneration of articular cartilage

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2
Q

OA classified as inflammatory or noninflammatory?

A

Noninflammatory

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3
Q

Common sites affected by primary OA (5)? BE SPECIFIC

A

Hands (DIP & PIP joints, 1st MCP joint, CMC Joint)
hips
knees
spine (usually cervical and lumbar vertebrae)
feet (1st MTP Joint)

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4
Q

What is the most common disabling joint disease?

A

You guessed it. Osteoarthritis.

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5
Q

Greatest risk factor for developing OA? Others?

A

Age = 75% of persons over age 70 have OA

Others include obesity, trauma, hereditary, female sex, neuromuscular dysfunction, metabolic disorders

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6
Q

Instead of being systemic and inflammatory, OA is considered to be?

A

Localized and degenerative. Only involves certain joints, not associated with warmth of skin or erythema (signs of inflammation)

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7
Q

Normal articular cartilage has what 2 important components? Purpose of each?

A

Normal articular cartilage has:

1) Proteoglycans - provide elasticity
2) Type II Collagen - provides tensile strength

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8
Q

In OA, what is the importance of cytokines? List 1 cytokine Dr. Gupta mentioned

A
  • Cytokines active metalloproteinases (MMPs)
  • MMPs degrade proteoglycans and collagen

Dr. Gupta mentioned IL-1 that could potentially mediate these effects (she also said they didn’t make “men” like Tyler anymore)

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9
Q

Early OA, what is going on in the cartilage?

A

Fibrillation and cracking of the matrix of articular cartilage.
Washout of proteoglycans.
Colonies “clones” of regenerating cartilage cells to try and replace the damaged chondrocytes

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10
Q

Within joint margins of OA patients, what can occur?

A

Osteophyte formation = reactive bone formation (can cause a slight increase in Alk Phos)

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11
Q

In advanced stage OA, what 2 important features occur?

A
  1. Development of subchondral bone cysts = fibrous lines “cysts” under the exposed subchondral bone
  2. Eburnation = highly polished appearance of exposed subchondral bone
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12
Q

What are joint mice?

A

fragments of articular cartilage that break free into the joint space

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13
Q

Joint stiffness and OA, what about it?

A

Minimal morning stiffness (

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14
Q

Joint pain and duration in OA?

A

As opposed to RA, pain gets better throughout the day

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15
Q

What physical exam finding can be observed in patients with OA? (vague question, just look at answer)

A

Crepitus

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16
Q

Range of motion in OA?

A

Decreased…obviously

17
Q

Enlargement of DIP joints results in?

A

Heberden nodes (osteophyte formation)

18
Q

Enlargement of PIP joints results in?

A

Bouchard nodes (osteophyte formation)

19
Q

Laboratory Tests to diagnose OA?

A

No specific tests, ESR and CRP are both usually normal

20
Q

Most common location in hand affected by OA?

A

Carpometacarpal joints

21
Q

If a patient has OA in “wrong” joint, i.e. the ankle, would should you be thinking?

A

Must consider secondary causes of OA

22
Q

List some common secondary causes of OA?

A
  • Trauma and/or overuse of joint (in younger patients)
  • Neuromuscular disease, especially diabetic or other neuropathies
  • Metabolic disorders (esp pseudogout aka CPPD aka Calcium pyrophosphate deposition disease)
23
Q

Secondary OA as a result of Diabetic Neuropathy. List clinical findings that could indicate this

A
  • MTPs (metatarsophalangeal joint) 2-5 involved in addition to 1st bilaterally
  • Destructive changes on Xray much worse than primary OA
  • Midfoot involvement is common
24
Q

Patient has hemochromatosis and OA. What are you thinking?

A

CPPD Disease (calcium pyrophosphate deposition disease aka pseudogout)

25
Q

1st line therapy for OA?

A

Acetaminophen

26
Q

2nd line therapy for OA?

A
  • NSAIDs if acetaminophen fails
  • Intra-articular agents or lavage
  • Opioids
27
Q

3rd line therapy for OA?

A

Arthroscopy
Osteotomy
Total Joint replacement
Cyanide…just kidding!

28
Q

2 types of intra-articular therapy for OA?

A
  1. Intra-articular steroids

2. Hyaluronate injections

29
Q

Stretching school advice you would give an OA patient?

A
  • Weight loss
  • decrease weight bearing
  • Increase range of motion exercises
    this concludes the module on treatment therapies presented at UTHSC - PT school. Off to the gym