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GI/Rheumatology Module > Pathophysiology of Osteoarthritis > Flashcards

Pathophysiology of Osteoarthritis Flashcards

1
Q

What is the definition of Osteoarthritis?

A

A heterogenous group of conditions that lead to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bones at the joint margins

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2
Q

In Osteoarthritis what can be observed?

A
  1. Cartilage is lost
  2. Imbalance of degradation and repair
  3. All joints are NOT affected equally
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3
Q

What is the most common form of arthritis?

A

OA

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4
Q

What is a major cause of long term disability?

A

QA

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5
Q

What are the systemic factors that are affected by OA?

A

Makes cartilage more vulnerable to repeated injury, it is less capable of repair

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6
Q

What are factors influencing susceptibility to OA?

A
  1. Age
  2. Sex
  3. Genetics
  4. Obesity
  5. Occupation
  6. Sports
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7
Q

Prevalence and Severity of disease increases with what?

A

Age

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8
Q

What are the possible mechanisms of increased OA with aging?

A
  1. Reduced repair
  2. Ligament laxity
  3. Muscle weakness
  4. Neurologic slowing
  5. Reduced non-calcified
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9
Q

Which sex has a higher risk of OA age below 45?

A

Males

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10
Q

Which sex has a higher risk of OA age above 55?

A

Female

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11
Q

Which sex has a higher risk of OA in the hands and knees?

A

Women

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12
Q

If your parents had OA, what is your risk for OA?

A

HIGHER and EARLIER

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13
Q

Is obesity a modifiable risk factor?

A

YES

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14
Q

With increased weight what increases?

A

Increased knee OA and increased risk

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15
Q

How is occupation a risk factor of OA?

A

Repetitive trauma, overuse, and overloading

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16
Q

What types of sports lead to OA?

A

Sport injuries, high intensity, direct impact, and repetitive impact

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17
Q

Does recreational running lead to OA?

A

Not really, unless they are already predisposed to OA where running could add additional stress

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18
Q

What is Primary OA?

A

Idiopathic

19
Q

What is Secondary OA?

A

Identifiable cause Present

20
Q

What is Generalized OA?

A

At least 3 local sites involved

21
Q

What are the local sites?

A
  1. Hands
  2. Feet
  3. Knees
  4. Hips
  5. Spine
  6. Shoulder
22
Q

What is Localized OA?

A

1 site

23
Q

What is DISH?

A

Diffuse Idiopathic Skeletal Hyperostosis: large, numerous osteophytes, affect the spine

24
Q

What is Normal Articular Cartilage?

A

Thin, vascular, neural covering of bone in joints

25
Q

What is Normal Articular Cartilage composed of?

A
  1. Water
  2. Type II Collagen
  3. Proteoglycans
26
Q

What does collagen do?

A

Provide structure, strength, and shape

27
Q

What are proteoglycans?

A

Protein cores with linked disaccharides

28
Q

What do glycosaminoglycans do?

A

Draw in water, restricted by collagen

29
Q

What does cartilage do?

A

Provide resilience, elasticity, and lubrication to joint

30
Q

What do chrondrocytes do?

A

Control synthesis and degradation

31
Q

What is obtained from synovial fluid?

A

Nutrients

32
Q

Eventually, underlying bone is revealed leading to reactive bone changes, causing what pathologic changes?

A
  1. Irregular thickening, sclerosis and remodeling of bone
  2. Cysts in bone underlying cartilage
  3. Marginal osteophyte formation
33
Q

What is seen in EARLY OA?

A

Decrease extracellular matrix, Increase water

34
Q

What is changes are seen in OA?

A

DECREASE chondrocytes and proteoglycan

35
Q

What happens to the degraded proteoglycans?

A

They are released into synovial fluid causing inflammatory response

36
Q

New bone growth at joint margins is classified as what?

A

Osteophytes

37
Q

What causes would classify Secondary OA?

A
  1. Trauma
  2. Abnormal joint stresses or mechanics
  3. Genetic abnormalities of the cartilage
  4. Metabolic or endocrine abnormalities
  5. Crystal deposition
  6. Inflammatory conditions of joints
  7. Avascular necrosis
  8. Neuropathic
38
Q

What are the clinical symptoms of OA?

A
  1. Joint pain
  2. Stiffness with inactivity
39
Q

What is joint pain described as in OA?

A

Use related, later also at rest or night pain

40
Q

What is stiffness with inactivity described as in OA?

A

Gelling, short duration

41
Q

What joints are at the Highest Risk of OA?

A
  1. Distal and Proximal Interphalangeal Joints
  2. 1st Carpometacarpal Joint
42
Q

What are the clinical signs of OA?

A
  1. Enlargement and Deformity
  2. Coarse crepitus
  3. No clinical signs of inflammation
  4. Restricted painful movements decreased range of motion
  5. Instability
43
Q

What are the forms of enlargement and deformity?

A
  1. Heberden Nodes DIP Nodules
  2. Bouchard Nodes PIP Nodules
44
Q

What is a main X-Ray finding in OA?

A

Joint space narrowing due to cartilage loss

GI/Rheumatology Module (18 decks)

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