P&T Jan 2023 Flashcards
OSTEOARTHRITIS
commonly affects hips, knees, SIJ, distal interphalangeal joints, carpometacarpal joints, wrists and C-spine
Aetiology:
-Age (45-65 onset)
-Obesity
-Trauma
-Congenital deformities
-Sex hormones (menopause)
-Female
-Infection (septic arthritis)
-Metabolic/endocrine disorders
-Occupation
Pathophysiology:
1.-Progressive cartilage breakdown due to degeneration of joints
2.-Breakdown of the cartilage causes joint space to narrow & bones to be exposed therefore rubbing against each other causing sclerosis of the surrounding bone
3.-This bone-to-bone friction causes osteophytes to form
Clinical features:
Signs:
-Bone enlargement
-Crepitus
-Tenderness on palpation
-Finger deformities
-Heberden’s nodes- DIP joints inflammation
-Bouchard’s nodes- PIP joints inflammation
-Squaring of base of the thumb
Symptoms:
-Joint pain and stiffness (worse in the morning but better with mild activity and worsens later in day)
-Worse with activity
-Morning stiffness less than 30 mins
-Pain better with rest
X-Ray findings:
L – Loss of joint space
O – Osteophytes
S – Subchondral sclerosis (increased density of the bone along the joint line)
S – Subchondral cysts
Potential cautions/contraindications:
Management:
-Weight loss
-NSAIDs
-Intra-articular steroid injections
-Joint replacement
