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Year2 MSK exam2 > Osteoarthritis, Told, Part I > Flashcards

Osteoarthritis, Told, Part I Flashcards

1
Q

what is the msot common arthropathy

A

OA

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2
Q

OA involves what part of joint

A

cartilage

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3
Q

primary OA

A

aging or idiopathic

genetic: nodal OA

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4
Q

secondary OA

A

dut to disorders that damage joint surfaces

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5
Q

2 principle mech of OA

A

damage to normal articular cartilage by physical forces

defective cartilage failures under normal joint loading

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6
Q

what occurs with there is physical damage to cartilage in OA

A

chondrocytes react with degenerative enzymes

inadequate repair response

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7
Q

what are the defects of fundamental defective cartilage OA

A 
type II collagen gene defect (Ochronosis)
Ochronotic cartilage (pigmented and defective)
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8
Q

what are the pathologic characteristics of OA joint

A 
loss of cartilage
sclerosis
remodeling bone
osteophyte spurs
cystic changes
mild reactive synovitis
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9
Q

systemic Factors for OA

A 
age
obesity
genetics
gender W>M
menopause? maybe
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10
Q

local factors for OA

A 
muscle strength
joint proprioception
repetitive use
configuration of joint
trauma
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11
Q

common joints in OA

A 
cervical spine
lumbar spine
1st CMC
PIP
DIP
Hip
Knee
1st MTP
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12
Q

uncommon joints of OA

A 
shoulder
throacic spine
elbow
wrist
MCP
ankle
subtalar
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13
Q

What are signs of nodal OA

A

heberdens nodes
bouchards nodes
1st CMC joint: base of thumb

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14
Q

where are heberdens nodes

A

DIP

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15
Q

where are bouchards nodes

A

PIP

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16
Q

most common location OA

A

knee

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17
Q

Sx OA

A 
insidious onset
pain with movement
limitation motion, dec function
minimal stiffness after rest
referred pain
acute flares suggest another Dx
systemic Sx
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18
Q

why is OA painful

A

its the synovitis and ligament stretching
periosteal irritation, muscle spasms
intraosseous HTN

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19
Q

signs of OA

A 
bony changes in joint shape
crepitus
malalignment/instability
limited ROM
joint line tenderness
cool effusions
spasm or atrophy of adjacent muscles
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20
Q

what are the non specific Dx tests for OA

A

ESR, RF

synovial fluid

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21
Q

What do you see on XR for OA

A

cartilage loss/joint space narrowing
subchondral sclerosis
osteophytes at joint margins
subchondral cysts

22
Q

what are subsets of OA

A 
generalized
nodal
spondylosis
erosive
inflammatory
DISH
chondromalacia patellae
23
Q

DISH

A

diffuse idiopathic skeletal hyperostosis

24
Q

what occurs in spondylolysis

A

the pars interarticularis breaks

25
Q

what occurs in spondylolisthesis

A

pars interarticularis breaks and spine slips

26
Q

what is genu varus

A

wide knees

27
Q

what part of knee sees msot wear

A

medial compartment

28
Q

what are syndesmophytes

A

osteophytes that connect bones together

29
Q

what happends with spondylosis in cervical spine

A

dysphagea

30
Q

what happens with spondlyosis of lumbar spin

A

radiculopathy

31
Q

what causes DISH

A 
excessive osteophytosis of spine 3-4 segments
preservation of disc spaces
ligametnous calcifications
M>F
unilateral
32
Q

DISH is assoc with

A

DM

33
Q

up flowing osteophytes

A

DISH

34
Q

is DISH inflammatory

A

no

35
Q

where are the osteoblasts that cause DISH

A

in entheses

36
Q

what side is most often affected by DISH

A

R side

L side if have dextro cardia or situs inversus

37
Q

environmental factors for DISH

A

fluoride
synthetic retinoids
obesity
IGF-1

38
Q

calcifications of posterior longitudinal ligament

A

DISH

39
Q

best place to look for DISH

A

thoracic spine, flowing anterior osteophytes

40
Q

upward pointing lumabr osteophytes

A

DISH

41
Q

ligamentous calcification at enthesis

A

=whisker calcifications

DISH

42
Q

what is chondromalacia of patella

A

whiskering and abnormal rubbing/growth patella

43
Q

chondromalacia patella more common

A

wide hip women because more stress on knees

44
Q

Tx goals for OA

A

pain control
improve fucntion
enhance health related quality of life
avoid Rx

45
Q

how to manage OA

A 
education
weight loss
analgesics
NSAIDs
PT
OT
srugery
46
Q

What are SMOADs

A

structure modifying anti-osteoarthritis dugs

47
Q

types of SMOADs

A

matrix metalloprotesase inhibitors MMPI

residronate, doxy, glucosamine, chondroitin

48
Q

if inflammatory OA does not respond to cochicine

A

Ca pyrophosphate joint crystals

49
Q

Rx for inflammatory OA

A

colchicine

50
Q

pain relieved with rest
morning stiffness, goes away with movement
little articular inflammation

A

OA

Year2 MSK exam2 (17 decks)

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