Rheumatology: Osteoarthritis

Question 1

Osteoarthritis (OA) is a heterogeneous disorder characterized by the destruction (degeneration) of _____ and proliferation (hypertrophy) of the _____.

Answer 1

articular cartilage; contiguous bone

Question 2

What are the clinical features of OA?

Answer 2

joint pain, decreased joint mobility, hypertrophic bony

spurs (osteophytes), infrequent joint inflammation, and lack of systemic involvement

Question 3

What are the symptoms of OA?

Answer 3

1. Pain with use improved with rest
2. Stiffness - (less than 30 minutes long)
3. Relative preservation of function
4. age 40+
5. Not systemic

Question 4

What are the signs of OA?

Answer 4

1. Localized joint tenderness
2. Bony enlargement
3. Crepitance
4. Restricted movement
5. Variable swelling and/or instability

Question 5

What are the signs of OA-specific deformity?

Answer 5

1. Heberden’s and Bouchard’s nodes
2. Squaring of the 1st carpometacarpal joint
3. Genu varus
4. Hallux valgus
5. Cervical and lumbar spine spondylosis

Question 6

What is the difference btw a Heberden’s node and a Bouchard’s node?

Answer 6

Heberden = distal, Bouchard = proximal (B before H)

Question 7

What is hallux valgus?

Answer 7

bunion on big toe

Question 8

What does Genu varus look like?

Answer 8

bow-legged

Question 9

Name the 6 types of clinical syndromes of OA.

Answer 9

1. Primary generalized OA
2. Inflammatory/erosive OA
3. Isolated nodule OA
4. Unifocal large joint OA
5. Multifocal large joint OA
6. Unifocal small joint OA

Question 10

What will be found on xray in OA?

Answer 10

1. Loss of cartilage space
2. Bony sclerosis and eburnation
3. Cystic changes of subchondral bone
4. Osteophyte formation
5. Altered shape of bone
6. Joint effusion – non-inflammatory

Question 11

What specific patterns of x-ray changes will be found on xray?

Answer 11

1. “Gull wing” changes in the interphalangeal joints
2. Medial compartment disease of the knee
3. Horizontal osteophytes of the spine
4. Decreased joint space superiorly with relative medial preservation in the hip
5. Hallux valgus without other metatarsal disease

Question 12

What is one of the strongest risk factors for OA?

Answer 12

age

Question 13

How are women affected differently by OA?

Answer 13

they have a more severe disease and increased freq. of Heberden’s or Bouchard’s nodes

Question 14

What is the relationship btw sports and OA?

Answer 14

no increased risk- might actually be protective

Question 15

What are the 2 classifications of OA?

Answer 15

1. primary (idiopathic)

2. secondary (known events or factors)

Question 16

Which joints does OA tend to spare?

Answer 16

the ankle, wrist, shoulder, and elbow, unless significant trauma or other disease has occurred

Question 17

Does normal cartilage have BVs? Nerves?

Answer 17

no and no

Question 18

Cartilage is made of what 5 components?

Answer 18

1. Collagen (mostly type II)
2. Proteoglycans (glycosaminoglycans, water)
3. Matrix proteins
4. chondrocytes (metabolically active)
5. water