Week 6- Osteoarthritis Tutorial

Question 1

What is the medial meniscus?

Answer 1

Fibrocartilage that spans the knee medially between the medial condyle of the femur and the medial condyle of the tibia

Question 2

What is ballotable effusion?

Answer 2

When there is swelling on the knee cap that can be palpated, when lying down the patella is pushed downwards and when released it rebounds to a floating position

Question 3

What are some predisposing factors for osteoarthritis?

Answer 3

Age
Gender
Obesity
Genetic predisposition

Question 4

What does a partial menisectomy give a greater risk of osteoarthritis than a total menisectomy?

Answer 4

When the meniscus is completely removed the bones cant grind against each other which reduces the pressure on the joint but partial removal of cartilage will increase pressure

Question 5

What is an osteophyte?

Answer 5

A part of the bone that sticks out

Question 6

How would an ideal x ray be taken if osteoarthritis is suspected and why?

Answer 6

With the patient standing up as the joint space narrowing is much more obvious this way

Question 7

What are some medical treatments for osteoarthritis?

Answer 7

Topical NSAIDs
Analgesia
Opioids
Steroid injection

Question 8

What are some conservative treatments for osteoarthritis?

Answer 8

Exercise
Weight loss
Physiotherapy
Walking aids

Question 9

What are some surgical treatments for osteoarthritis?

Answer 9

Partial knee replacement
Total knee replacement
Osteotomy

Question 10

What are some questions to ask patients who have pain in joints?

Answer 10

How bad is it 1-10 right now?
Does it interfere with sleep or ever wake you up?
Does the pain radiate?
Is it worse after exercise?
Where exactly is it located?

Question 11

What do varus and valgus mean?

Answer 11

Varus- big toe points medially, knees go out laterally

Valgus- big toe points laterally, knees go in medially

Question 12

What is transfer metatarsalgia?

Answer 12

When pressure is put on other toes due to pain in one toe

Question 13

What is an osteotomy?

Answer 13

A surgical procedure involving breaking a bone and resetting it

Question 14

What is the medical name for bone fusion? Where is it commonly done?

Answer 14

Arthrodesis- only done on small joints as it prevents movement of the joint eg wrist, toes, would never do on a knee

Question 15

What is the medical name for the big toe?

Answer 15

Hallux valgus

Question 16

Why is the incidence of OA increasing in the UK?

Answer 16

Obesity
Ageing population
More sports injuries

Question 17

Describe the rough pathogenesis of OA

Answer 17

Degredation of collagen creates products that induce the presence/recruitment of chemicals that cause secondary inflammation

Question 18

Why are too many steroid injections (eg to treat OA) dangerous? What is the max no of injections that should be given?

Answer 18

Steroids are anti-inflammatory and joints heal via inflammation. They therefore induce reduced immune response at joints which van increase risk of infection. Therefore giving more than 3 injections is not recommended