Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 LCRS Musculoskeletal > rheumatology and orthopaedics > Flashcards

rheumatology and orthopaedics Flashcards

osteoarthritis: summarise the pathogenesis, clinical features and management of osteoarthritis

1
Q

define osteoarthritis

A

chronic slowly progressive disorder due to failure of articular cartilage that typically affecting joints of the hand (especially those involved in pinch grip), spine and weight-bearing joints (hips and knees)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what age group does osteoarthritis usually affect

A

elderly (wear-and-tear)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

joints affected in osteoarthritis not affected in rheumatoid arthritis

A

distal interphalangeal joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

joint feel in osteoarthritis vs rheumatoid arthritis

A

in osteoarthritis, joints feel bony and hard; in rheumatoid arthritis, joints feel spongy and soft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

general locations of joints affected in osteoarthritis

A

hand, spine, weight-bearing joints of lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

joints affected in osteoarthritis: hand

A

distal interphalangeal joints, proximal interphalangeal joints, first carpometacarpal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

joints affected in osteoarthritis: weight-bearing joints of lower limbs

A

knees, hips, first metatarsophalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are osteophytes

A

bony projections (‘spur’) associated with degeneration of cartilage at joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are osteophytes at the distal interphalangeal joints called

A

Heberden’s nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are osteophytes at the proximal interphalangeal joints called

A

Bouchard’s nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

6 associations of joints in osteoarthritis

A

pain, crepitus, instability, enlargement, stiffness and immobility (‘gelling’), limitation of motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when is joint pain caused by osteoarthritis better/worse

A

worse with activity, better with rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is joint crepitus in osteoarthritis

A

creaking, cracking grinding sound on moving affected joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what causes joint enlargement in osteoarthritis

A

osteophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how long does joint stiffness after immobility (‘gelling’) in osteoarthritis take to go away vs rheumatoid arthritis

A

much faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

in osteoarthritis, what is joint instability caused by

A

atrophy of muscles around joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what joint movement is the first to be affected in osteoarthritis

A

internal rotation of hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

4 radiographic features of osteoarthritis

A

joint space narrowing (lack of articular cartilage), subchondral bony sclerosis (appear much whiter), osteophytes, subchondral cysts (appear circular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

rheumatoid vs osteoarthritis: joint space narrowing

A

both

20
Q

rheumatoid vs osteoarthritis: subchondral sclerosis

A

rheumatoid: no vs osteoarthritis: yes

21
Q

rheumatoid vs osteoarthritis: osteophytes

A

rheumatoid: no vs osteoarthritis: yes

22
Q

rheumatoid vs osteoarthritis: osteopenia

A

rheumatoid: yes (juxta-articular osteopenia) vs osteoarthritis: no

23
Q

rheumatoid vs osteoarthritis: bony erosions

A

rheumatoid: yes (where synovium in contact with bone) vs osteoarthritis: no

24
Q

normal articular cartilage structure and purpose

A

normally smooth cartilage layer to distribute weight, with synovial fluid in joint capsule and synovial membrane around it

25
Q

osteoarthritic articular cartilage structure

A

undergoes fragmentation and atrophy, with some fragments entering synovial fluid which are visible in x-ray

26
Q

why does defective and irreversible articular cartilage and damage to underlying bone occur in osteoarthritis

A

excessive loading on joints and/or abnormal joint components

27
Q

osteoarthritis general pathophysiology

A

genetic predisposition -> abnormal stress or abnormal cartilage -> chondrocyte apoptosis -> loss of proteoglycans and collagen fibril damage

28
Q

causes of abnormal stress in osteoarthritis

A

obesity, manual job, trauma to joints which haven’t been set correctly

29
Q

causes of abnormal cartilage in osteoarthritis

A

ageing, inflammation, metabolic changes

30
Q

3 contents of synovial joint

A

synovium, synovial fluid, articular cartilage

31
Q

what is the main collagen type in synovium, and what cells make it up

A

type 1 collagen, with synovium consisting of synoviocytes

32
Q

what is synovial fluid

A

hyaluronic acid-rich viscous fluid

33
Q

what is collagen type and main proteoglycan of articular cartilage

A

type II collagen, with main proteoglycan being aggrecan

34
Q

property of synovial joint that allows robust strength from compression, that is lost in osteoarthritis

A

property to retain water (due to glycosaminoglycans in proteoglycans, with main proteoglycan in articular cartilage being aggrecan)

35
Q

what causes joint pain in osteoarthritis

A

bony spurs rubbing against skin, not collagen loss

36
Q

in articular cartilage, what are monomers arranged into

A

supramolecular aggregates consisting of central hyaluronic acid filament and non-covalently linked aggrecan

37
Q

what are glycosaminoglycans

A

repeating polymers of disaccharides

38
Q

3 cartilage changes in osteoarthritis

A

reduced proteoglycan, reduced collagen, chondrocyte changes e.g. apoptosis

39
Q

2 bone changes in denuded sub-articular bone in osteoarthritis

A

oroliferation of superficial osteoblasts causing production of sclerotic bone (subchrondral sclerosis), focal stress on sclerotic bone resulting in focal superficial necrosis

40
Q

purpose of osteophytes

A

unsure as to whether is it a primary feature of osteoarthritis or attempt of body to repair

41
Q

pain vs x-ray in osteoarthritis

A

poor correlation between what appears to be happening and pain felt (pain subjective)

42
Q

7 management strategies of osteoarthritis

A

education, physical therapy (physiotherapy, hydrotherapy; prevent muscles around joint undergoing atrophy and causing joint instability), occupational therapy, weight loss where appropriate, exercise, analgesia, joint replacement

43
Q

3 analgesic options to treat osteoarthritis

A

paracetamol, NSAIDs, intra-articular corticosteroid injection (no role of DMARDs)

44
Q

in osteoarthritis, when would you administer an intra-articular corticosteroid injection

A

last attempt, as they only last a couple of weeks and repetition damages cartilage further

45
Q

describe the benign prognosis of osteoarthritis

A

there is an initial painful phase (approx. 5 years), before subsiding (bony changes don’t go away, so pain could be bone remodelling)

46
Q

2 therapeutic approaches for osteoarthritis not approved in UK

A

glucosamine and chondroitin sulphate (placebo effect of replacing structures of joint, but unsure if even reaches joint), intra-articular injections of hyaluronic acid into knee (lubricant, but no evidence)

Y2 LCRS Musculoskeletal (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions