Pathophys - Osteoarthritis

Question 1

true or false

carpal tunnel is osteoarthritis

Answer 1

false - it’s not arthritis

Question 2

true or false

unlike rheumatoid arthritis, osteoarthritis is not chronic

Answer 2

FALSE
it is

Question 3

osteoarthritis causes the breakdown of what?

Answer 3

joint cartilage and underlying bone

Question 4

true or false

osteoarthritis is “ware and tare” arthritis

Answer 4

TRUE

Question 5

true or false

osteoarthritis is commonly seen unilaterally

Answer 5

TRUE

can still be bilateral, but characteristically unilateral

Question 6

is it possible to have bilateral osteoarthritis

Answer 6

yes - just more frequently unilateral

Question 7

name some sites that are likely to be affected by osteoarthritis rather than rheumatoid

Answer 7

large joints like hips, shoulders, knees, elbows

Question 8

baseball pitchers developing arthritis is what kind of arthritis?

Answer 8

osteoarthritis - “wear and tear”

Question 9

osteoarthritis is more so considered the disease of older or younger people?

Answer 9

older people
can affect younger, but consistent with repetitive ware and tear - and thus more frequently seen in older

Question 10

true or false

rheumatoid arthritis is the most common form of arthritis

Answer 10

FALSE

osteoarthritis is

Question 11

osteoarthritis is a ____ diseases that causes the breakdown of what 2 things

Answer 11

joint disease

causes the breakdown of joint cartilage and underlying bone

Question 12

name 3 causes of osteoarthritis

Answer 12

joint injury/mechanical stress

limb development abnormalities in utero

inherited factors - genetics can play a role

Question 13

true or false

genetics do not play a role in osteoarthritis

Answer 13

FALSE - it’s possible they do

Question 14

besides joint abnormalities in utero, joint injury/mechanical stress, and genetic factors, name 3 OTHER RISKS in developing osteoarthritis

Answer 14

being overweight
performing repetitive tasks
legs of different length

Question 15

explain how joint injury/mechanical stress can be a cause of osteoarthritis

Answer 15

it generates a low grade inflammatory process

Question 16

true or false

in osteoarthritis, there are NO visual signs of inflammation

Answer 16

true - no redness or heat

there is in rheumatoid

Question 17

what is Ehlers-Danlos syndrome?

Answer 17

caused by genetic mutation (multiple). a rare connective tissue disorder

causes loose joints and pain, stretchy skin, and abnormal scar formation

a secondary factor in developing osteoarthritis

Question 18

symptoms of this disease are having loose joints, joint pain, stretchy skin, and abnormal scar formation

Answer 18

ehlers-danos syndrome

secondary factor in developing osteoarthritis

Question 19

_____ DOUBLES the risk of developing osteoarthritis

Answer 19

diabetes

Question 20

is ehler-danlos syndrome autosomal dominant or recessive?

Answer 20

may be either

Question 21

what is alkaptonuria?

Answer 21

a secondary factor in developing osteoarthritis

a genetic metabolic disorder where the body can’t process phenylalanine and tyrosine, resulting in an accumulation of homogenistic acid in the body WHICH CAN DAMAGE JOINTS

there is a mutation in the gene that encodes for the enzyme that breaks down phenylalanine and tyrosine (homogentistate 1,2,3-deoxygenase)

Question 22

what is the pattern of inheritance of alkaptonuria?

Answer 22

autosomal recessive

Question 23

what is marfans syndrome and what is the pattern of inheritance?

Answer 23

a genetic disorder of connective tissue - secondary factor in developing osteoarthritis.

autosomal dominant

the result is tall, thin people with long arms, legs, fingers, toes and hyperflexible joints. may involve heart valves. can cause aortic aneurysm and eye ligament weakness

caused by a mutation in FBN1 gene — supposed to produce fibrillin 1 (glycoprotein) which is essential for the proper formation of ECM – especially elastic fibers – leads to issues in making healthy connective tissue and makes joints that dont work properly – begin to wear

Question 24

as mentioned, Marfans syndrome can affect heart valves
explain further

Answer 24

can cause mitral valve prolapse and aortic aneurysm

Question 25

name 2 secondary factors that can cause osteoarthritis through the accumulation of certain elements

Answer 25

hemochromotosis - buildup of iron

wilsons disease - buildup of copper

both are rare genetic disorders

Question 26

true or false

a chronic inflammatory disease can lead to the development of osteoarthritis

Answer 26

true

Question 27

as mentioned, a chronic inflammatory disease can lead to the development of osteoarthritis

name 2 of them

Answer 27

lyme disease
gout

Question 28

true or false

acute joint infections cannot lead to the development of osteoarthritis

Answer 28

FALSE - they can

this is bc joint infections can lead to permanent damage of the joint due to the inflammatory process and cause it to not work properly, resulting in the developing of osteoarthritis

Question 29

explain the pathophysiology of osteoarthritis

Answer 29

balance between compressive forces on joint vs hydrostatic pressure of the water contained in cartilage

compressive forces squeeze cartilage down, hydrostatic keeps cartilage in proper form

exert too much compressive force - proteoglycans lost and water forced out. proteoglycans responsible for maintenance of hydrostatic pressure and hydration which keeps water in and cartilage open and in proper place

increased compressive forces from continual stress – causes decrease in proteoglycan content –> water content decreases –> force keeping cartilage in proper structure is decreased.

this reduced osmotic pressure causes additional stress on collagen fibers in the cartilage, causing them to breakdown.

in summary, when the balance is lost and hydrostatic pressure decreases, compressive forces breakdown collagen

Question 30

as mentioned, when the balance between hydrostatic pressure and compressive pressure is lost, collagen fibers within the cartilage between the 2 bones starts to breakdown.

what is the result of this?

Answer 30

the breakdown of collagen results in an inflammatory process which FURTHER INJURES the cartilage, thru the release of proteolytic enzymes (like metalloproteases)

Question 31

as mentioned, the breakdown of collagen results in the induction of inflammatory processes through the release of proteolytic enzymes like metalloproteases.

what is the result of this inflammatory process?

Answer 31

breakdown of further elements in joint.

ligaments

joint capsule may become fibrotic and thicken

meniscus (cartilage covering of bone) can be torn away

Question 32

in which cells are metalloproteases found?

Answer 32

synoviocytes, macrophages, and neutrophils – all associated with inflammation

Question 33

what is the result of the wearing away of cartilage in osteoarthritis?

name 2 things

Answer 33

makes movement difficult

puts pressure directly on the head of the bone – can spur bone growth (form a growth) and head of bone becomes misshapen as result of pressure

further interferes with articulation of the 2 bones

Question 34

the spur (bony growth) that forms from the pressure of bone on bone can do what?

Answer 34

forms a joint mouse - loose piece of cartilage or bone and cartilage

can cause crepitus (popping or cracking sound)

the joint may disarticulate and nearly completely lose function

Question 35

what maintains the hydrostatic/osmotic pressure within cartilage between bones?

Answer 35

proteoglycans

Question 36

what is crepitus?

Answer 36

grating sensation or sound when moving a joint - due to bone rubbing against each other

Question 37

what is ankylosis?

Answer 37

condition in which 2 bones rub against each other

Question 38

what do ligaments connect?

Answer 38

connect bones and joints