T&O: Osteoarthritis Flashcards
Describe the four features of OA on XRAY
Subchondral sclerosis, narrowing of joint space, osteophytes, bony cysts (SNOB)
How may OA present?
Deep aching pain in the joint which is exacerbated by use.
Reduced range of motion.
Grinding sensation/sound.
Stiffness during rest - morning stiffness usually lasts less than an 30mins.
Name categories of secondary OA
post-traumatic, post-operative, inflammation/infection related, miscellaneous
What may you find on examination of someone with OA?
Swelling of joint,
joint deformity,
tenderness on palpation,
joint effusions,
restricted/reduced movements,
joint instability,
weakness or wasting
To be considered for a knee replacement, what three features need to be present during a knee examination?
Correctable varus,
full extension of the leg (at the knee),
flexion of at least 100 degrees
What management options are available for OA?
Analgesia (e.g. NSAIDS - ibuprofen 200mg, naproxen 500mg initially, then 250mg every 6-8 hours as required). Steriodal injection. Weight loss. Use of walking stick. Surgery - partial or total knee replacement.
What condition can predispose to a Baker’s cyst?
OA
Causes of OA?
Idiopathic,
infection,
inflammation,
trauma
Name two risk factors for OA?
Increasing age, genetic factors, female, obesity, low bone density, previous joint injury, occupational or recreational stress, joint laxity, malignancy, surgery.
How does OA present in the knee?
Pain around knee. Pain can radiate to hip/thigh. Made worse by walking/exercise. Better when resting. Stiff in knee joint, swollen, crepitus, reduced range movement, bilateral.
How does OA of hip present?
Chronic worsening sx, pain, stiffness, grinding sensation, relieved by rest, aggravated by activity. Pain in hip can radiate to groin, anterior thigh or can present as pain in the knee (referred).
What would you find on examination of pt with OA of hip?
Antalgic gait, tenderness round hip. Passive movements are often painful, crepitus. reduced range of movement. Fixed flexion deformity on Thomas test. Trendelenberg gait.
What investigations would you order for suspected OA of hip?
XR. May want MRI too.
What are risk factors for OA of hip?
Primary - female, obesity, manual handling occupation, increasing age. Secondary - connective tissue disorders - RA, Marfans, Trauma, Infiltrative diseases
What is involved in conservative management of OA of hip?
Lose weight. Minimise aggravating activity. Use walking aids. Meds - NSAIDs (remember to give PPI!), corticosteroid injection, Acetminophen.
