Osteoathritis Flashcards
What is osteoathritis?
Tear, flare and repair
affects more than half the UK population
Caused by trauma and mechanical pain
This leads to inflammation and pain
Repair processes occur around the joint
What biochemical factors can lead to osteoarthritis?
Abnormal anatomy (DDH) Intra-articular fracture Ligament rupture Meniscal injury Occupation- farmers football players Elite running Obesity
What causes inflammation in osteoathritis?
Synovial hypertrophy
Subchondral changes
Joint effusion
What biochemical factors mediate osteoarthritis?
IL-1, TNF, MMP’s
What is the pathogenesis of osteoarthritis
Musle wekaness, ligament injury, anormal anatomy lead to obesity and instability. This causes joint microtrauma and an osteoarthritic joint
How do you diagnose osteoarthritis
Over 45 years
Activity related join pain plus
Has no morning joint related stiffness, or morning stiffness that lasts no longer than 30 minutes
What symptoms makes you think it isn’t osteoarthritis?
Trauma
Prolonged morning related stiffness
Rapid deterioation of symptoms
Hot, swollen joint
What are some differential diagnosis for osteoarthritis?
How can you investigate osteoarthritis?
Gout, inflammatory arthritides
Septic arthritis
Malignancy
X-ray
Who manages osteoarthritis?
Nurses Physicians GP's Patients Dieticians Occupational therapists Physiotherapists Orthopaedic surgeons
How should patients manage osteoarthritis?
Holistically and through self management is the first step
This involves expanding their knowledge of OA, recognising and combating the effects it can have on occupation, mood, sleep, support network, exercise
Pain assessment
What are the core treatments of arthritis?
information
exercise
weight loss
What are some non-pharmacological treatments of osteoarthritis?
Thermotherapy Electrotherpay Aids and devices Manual therapy NICE do not recommend acupuncturem butraceuticals
What are the pharmacological treatments of osteoarthritis?
Oral analgesia:paracetamol, NSAIDS
Topical treatments: NSAIDS,capsaicin
Intra-articular injections: steroids (hyaluronic acid)
When do you refer for surgery
Substantail impact on quality of life
Refractory to non-sugical treatment
Referral letter
To summarise osteoarthritis?
Significant cause of morbidity
Pathogenesis is not entirely clear
Tailor treatment to individual patient
Consider surgical management when other options are exhausted and quality of life is suffering
