Osteoarthrosis

Question 1

What are the typical radiological findings of OA?

Answer 1

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

Question 2

What is the strongest clinical indicator of OA of the hip?

Answer 2

Pain (groin and anterior thigh) exacerbated by internal / external rotation

Question 3

Why may you assess the ROM of the knee joint and lower lumbar spine in a patient with hip pain?

Answer 3

Rule out referred pain from those joints

Question 4

Other than the hip and knees, what other joints are typically affected in OA?

Answer 4

Spine, in particular cervical and lumbar spines

Question 5

Mention the types and causes of osteoarthritis

Answer 5

Primary

Secondary as a result of

• Trauma (athletes, heavy lifting)
• Inflammatory (RA, Septic, Gout)
• Neuropathic (DM, syringomyelia, tabes dorsalis)
• Endocrine (acromegaly, hyperparathyroidism)
• Metabolic (chndrocalcinosis, haemochromatosis)

Question 6

What is syringomyelia?

Answer 6

Rare disorder

Fluid filled cyst develops within spinal cord that gradually expands and compresses the cord centre outwards

Question 7

What is tabes dorsalis?

Answer 7

aka Syphlitic Myelopathy

Slow demyelination of neural tracts in the dorsal column and dorsal roots

Question 8

How would you manage a patient with OA?

Conservative, Medical, Surgical

Answer 8

Conservative

• Weight loss
• Activity, strength exercises

Medical

• NSAIDs
• Rubifacients
• COX-2 inhibitors
• Intra-articular injections

Surgical

• Athroscopic removal of foreign body
• Arthroscopic wash out
• Replacement