Osteoarthritis - Told Flashcards
ostearthritis
not inflammation
most common arthropathy
osteoarthritis
enzyme degradation
osteoarthritis
multi-factorial etiology
nodal osteoarthritis
genetic
secondary OA
due to disorders damaging joint surface
progressive deterioration and loss of articular cartilage - leading to loss of normal joint structure and function
osteoarthritis
mechanisms of path in OA
1 - damage to normal articular cartilage - physical forces - macro and microtrauma
- chrondrocytes react - release degradative enzymes
- inadequate repair
2 - fundamental defective cartilage fails under normal loading - type II collage gene defect - ochronosis
ochronosis
type II collagen gene defect
-cannot handle normal loading
get osteoarthritis
pigmented and defective cartilage
ochronotic cartilage
sclerosis
subchondral bone thickening
-in osteoarthritis
risk fx for osteoarthritis
age obesity genetics gender menopause - possible hormone issues
common cause of back pain
osteoarthritis
DIP osteoarthritis
heberdens
PIP osteoarthritis
bouchards
1st CMC joint
base of thumb
compartments of knee
medial, lateral, patellar/femoral
pain in osteoarthritis
cartilage - no pain
but get synovitis capsule/ligament stretching trabecular microfractures muscle spasm intraosseous HTN
stiffness at rest
with RA
acute flares of pain
crystal disease
systemic sx of OA
no
joint pain with movement, slow onset, limited motion and decreased function
osteoarthritis
cool effusion
in osteoarthritis
clear fluid - on aspiration
class I
class I synovial fluid
non-inflammatory clear high viscosity form mucin clot low WBC count culture negative
ESR and RF in OA
negative
arthroscoped of OA
shredded artcilage
spondylolysis
defect of pars interarticularis
spondylolisthesis
translated vertebra
knee bow out
genu varus
knock kneed
genu valgus
coxarthrosis
degeneration of hip joint due to OA
bunion
foot with OA
osteophyte
bone spur
spondylosis
degenerative OA of joints between spinal vertebra
spondylitis
inflammation of vertebra
syndesmophytes
ligament ossify around vertebra
bamboo spine
DISH
diffuse idiopathic skeletal hyperostosis
exuberant osteophytosis of spine/spans >3-4 vertebral segments
DISH
preservation of disc spaces
ligament calcification
associated with diabetes mellitus
more in men
anterior cervical osteophytes
dysphagia
up flowing osteophytes
DISH
ossification to the tendons
causes DISH
point of origin for osteophyte
enthesis
most common spinal ossification
right sided
dextrocardia
left sided ossification
don’t know cause
environmental factors with DISH
fluoride
synthetic retinoids - acutane
obesity
IGF-1
best place to look for DISh
thoracic spin
upward pointing osteophytes, ligamentous calcification at enthesis, foot and ankle heel spur
all characteristic of DISH
chrondromalacia of patella
with wide Q - angle
wear of medial patella
tx goals for OA
pain control
improve function
enhance QOL
avoid drug related side effects
SMOADs
structure modifying osteoarthritis drugs
matrix metalloprotease inhibitiors residronate doxycycline glucosamine chrondroitin
inflammatory osteoarthritis fails to respond to tx
think calcium pyrophosphate joint crystals
positive birefringence**
