OSTEOARTHRITIS Flashcards
DEFINE
CHRONIC DEGENERATIVE NON INFLAMMATORY DISORDER OF THE SYNOVIAL JOINT CHARACTERISED BY DESTRUCTION OF ARTICULAR CARTILAGE AND FORMATION OF NEW BONE AT THE JOINT SURFACE AND MARGIN
TYPES
PRIMARY
SECONDARY
PRIMARY
OCCURS IN JOINT DE NOVO
OLD AGE MAINLY KNEE AND HIP
MORE COMMON
JOINTS AFFECTED
HANDS = DIP AND PIP
KNEE
HIP
SPINE
SECONDARY
COMMONLY AT HIP
UNDERLYING PRIMARY DISEASE
MAY BE SEEN IN
MALUNITED FRACTURE
COXA VARA
CDH
SEPTIC ARTHRITIS
PATHOLOGY
INCREASE IN WATER CONTENT
DEPLETION OF GLYCOPROTEIN FROM CARTILAGE MATRIX
REPEATED WEIGHT BEARING
CARTILAGE ABRADED BY GRINDING MECHANISM
UNDERLYING BONE EXPOSED AND GETS HARD
SUBCHONDRAL BONE HYPERTROPHIED TO FORM OSTEOPHYTES
SIMILARLY SUBCHONDRAL CYST AND SCLEROSIS FORMS
LOOSE FLAKES OF CARTILAGE IN THE SYNOVIAL FLUID ( LOOSE BODIES )
THICKENING OF CAPSULE
DEFORMITY AND STIFFNESS OF JOINT
CLINICAL FEATURES
PAIN - CHRONIC
CREPITUS
SWELLING
DEFORMITY
RESTRICTED MOVEMENT
STIFFNESS
ON EXAMINATION
TENDERNESS ON JOINT LINE
CREPITUS ON MOVING JOINT
OSTEOPHYTES
DEFORMITY - FLEXION ADDUCTION AND EXTERNAL ROTATION
WASTING OF QUADRICEPS MUSCLE
INVESTIGATION
RADIOLOGICAL
SEROLOGY
ESR
SERUM URIC ACID
ARTHROSCOPY IF LOOSE BODIES OR FRAYED MENISCI SUSPECTED
RADIOLOGICAL - XRAY
@ LOSS
LOSS OF JOINT SPACE
OSTEOPHYTES
SUBCHONRAL CYST
SUBCHONDRAL SCLEROSIS
LOOSE BODIES
TREATMENT
NON OPERATIVE =
ANALGESICS
VISCOSUPPLEMENTATION - SODIUM HYALURONATE
CHONDROPROTECTIVE AGENTS - GLUCOSAMINE, CHONDROITIN SULPHATE
SUPPORTIVE THERAPY -
WEIGHT REDUCTION
LOCAL HEAT
EXERCISE
AVOID SITTING CROSSED LEGS AND SQUATTING
OPERATIVE
OSTEOTOMY
JOINT REPLACEMENT
JOINT DEBRIDEMENT
ARTHROSCOPIC PROCEDURES TO REMOVE LOOSE BODIES AND MENISCAL TEARS
COMPLICATION
ROTATOR CUFF TEAR
LOOSE BODIES
CAPSULAR HERNIATION
SPINAL STENOSIS
SPONDYLOLISTHESIS
