Rheum week 1 - bilateral knee pain Flashcards
What is the difference is typical onset pattern of inflammatory arthritis Vs osteoarthritis ?
IA = onset over weeks/months (acute)
OA = onset over months/years (chronic)
what are the common sites of osteoarthritis ?
- cervical spine
- lumbar spine
- hips
- hands (base of thumb, PIPs and DIPs)
- knees
- feet
What are some potential findings in a knee examination of an OA patient ?
- cool knee
- small effusion
- crepitus
After history and examination findings support a diagnosis of OA, what test can be done to confirm the diagnosis ?
NICE suggests no further tests are required
Which hand joints are affected by heberdens nodes ?
DIPs
Which hand joints are affected by bouchards nodes ?
PIPs
What is the typical joint patter of osteoarthritis ?
- small and large joint
- symmetrical
- oligo/polyarthritis
What are the treatment options for OA ?
conservational
- patient education
- weight loss
- exercise/physiotherapy
pharmacological
- analgesia (paras -> NSAIDs -> opiods)
- intra-articular steroid injections for moderate/severe pain if other methods are any successful
surgical
if other methods aren’t sufficient and symptoms have substantial impact on QOL
How long does pain relief last after a steroid injection for arthritis ?
2-10 weeks (short term relief)
How common is Osteoarthritis?
50-80% of pop over 65yrs will have evidence of OA on an XR
almost all old people have it eventually
Explain OA to a patient …
OA is a very common condition where cartilage damage leads to increased bone growth around the joints (nodules), and thickening of the joint capsule and ligaments which causes stiffness, pain and swelling that gets worse over time (wear and tear)
what are the risk factors for OA ?
- increased age
- high BMI
- female gender **men get too but F>M*
- previous joint injury
- intense sport
- occupation
- poor knee alignment
- genetic
- secondary OA
What is secondary OA ?
- primary OA has no known direct cause
- secondary OA is caused by another disease, infection, injury or deformity
Which type of OA is most likely in patients under 40yrs ?
secondary OA
What are some secondary causes of OA ?
- trauma (fractures, surgery, injury)
- neuropathic (diabetes, syphilis)
- inflammatory (septic arthritis, any other inflammatory arthropathy)
- anatomical/genetic (unequal leg length, hyper mobility, congenital dislocations…)
- metabolic (gout, wilsons disease, acromegaly, haemachromatosis..)
