Topic 10: Osteoarthritis

Question 1

Osteoarthritis (OA)

Answer 1

slowly progressive noninflammatory disorder of the diarthrodial (synovial) joints, involving gradual loss of articular cartilage with the formation of bony outgrowths at joint margins

Question 2

what is the main symptom of osteoarthritis

Answer 2

joint pain

Question 3

in osteoarthritis pain gets ____ with use

Answer 3

WORSE

Question 4

joint pain relief with _______ in osteoarthritis

Answer 4

REST

Question 5

clinical manifetations of osteoarthrits

Answer 5

-joint pain/stiffness
-CREPITUS “crunch sound”
-pain is more with activity and less with rest
-usually affects one joint on one side of the body
-node formation (Heberden nodes and Bouchards nodes)

Question 6

Herberden’s nodes

Answer 6

Hard nodules or enlargements
of the distal interphalangeal
joints of the fingers (DIP)

Question 7

Bouchard nodes

Answer 7

Hard nodules or enlargements
of the proximal interphalangeal
joints of the fingers (PIP)

Question 8

diagnostic assessment for osteoarthritis

Answer 8

· X-ray, CT scan, MRI, bone scan
Possible synovial fluid analysis (helps determine OA from other inflammatory arthritis)

Question 9

management for osteoarthritis

Answer 9

· Nutritional and weight management counseling
· Rest and joint protection, use of assistive devices
· Therapeutic exercise (aerobic conditioning, ROM)
· Heat
· CAMS: herbs and nutritional supplements like fish oil, ginger, SAM-e, movement therapy (Tai Chi), acupuncture, massage
· Stress importance of warming up before any exercises to decrease risk of injury

Question 10

ambulatory care interventions for osteoarthritis

Answer 10

· Remove throw rugs, place rails at stairs and bathtub, use lights
Wear well-fitting supportive shoes

Question 11

patient teaching for osteoarthritis

Answer 11

· Balance activity and rest (rest during periods of acute inflammation)
· Avoid immobilization for more than one week because of the risk of joint stiffness
· For patients with knee OA: avoid standing, kneeling, or squatting for long periods
· Discuss any supplement use with HCP to identify possible interact

Question 12

Joint protection and energy conservation

Answer 12

· Maintain healthy weight
· Use of assistive devices, if needed
· Avid forceful repetitive joint movements
· Avoid awkward positions that stress joints
· Use good posture and body mechanics
· Seek help with needed tasks that may cause pain
· Organize routine tasks and pace yourself to decrease fatigue and joint pain
Modify home and work environments to perform tasks in less stressful ways

Question 13

drug therapy for osteoarthritis

Answer 13

· Acetaminophen
· NSAIDs
· Intraarticular corticosteroids
· Topical agent: capsaicin cream
· Disease-modifying osteoarthritis drugs (DMOADs)

Question 14

Disease-modifying osteoarthritis drugs (DMOADs)

Answer 14

Drugs thought to slow the progression of OA or support joint healing