Osteoarthritis

Question 1

the breakdown of cartilage in osteoarthritis causes what?

Answer 1

causes bones to rub together and grow spurs (osteophytes)

Question 2

OA is the most common cause of _____ ______ in adults worldwide d/t pain and altered joint function

Answer 2

chronic disability

Question 3

what are the 6 areas that OA most commonly develops in?

Answer 3

neck
shoulders
hands
lower back
hips
knees

Question 4

what are 3 main causes of secondary OA?

Answer 4

genetic joint conditions
trauma
metabolic conditions

Question 5

what lab is usually low in OA?

Answer 5

leukocytes in joint fluid

Question 6

what is the prominent leukocyte found in the OA synovium?

Answer 6

macrophages

Question 7

how is OA characterized?

Answer 7

presence of proinflammatory mediators as well as anti-inflammatory cytokines

Question 8

what is the pathogenesis of OA?

Answer 8

proinflammatory factors > anti-inflammatory cytokines

Question 9

when is stiffness most prominent? (2)

Answer 9

morning
after periods of inactivity

Question 10

node that is on the joint closest to the fingertip (DIP joint)

Answer 10

Heberden’s node

Question 11

node that is on the middle joint of the finger (PIP joint)

Answer 11

Bouchard’s node

Question 12

which node may be associated with a digital myxoid (mucous) pseudocyst?

Answer 12

Heberden

Question 13

what views are recommended for xrays?

Answer 13

weightbearing views

Question 14

what is the goal of treatment of OA?

Answer 14

slow progression

Question 15

what is the non-op treatment for OA? (5)

Answer 15

NSAIDs
rehab
weight loss
bracing (knee)
+/- joint injections

Question 16

what analgesics can be used for non-op treatment? (3)

Answer 16

acetaminophen
oral NSAID
diclofenac topical

Question 17

what is the goal of physical therapy?

Answer 17

teach patient how to work out stiffness without further damaging joints

Question 18

why is physical therapy important?

Answer 18

not using joints causes worsening stiffness

Question 19

what are the 3 types of exercises appropriate for OA? how often should they be done?

Answer 19

ROM; everyday
strengthening; everyday
non-impact; 3x a week

Question 20

what is directly correlated to progression of knee, ankle, and foot OA?

Answer 20

BMI

Question 21

OA in which body part inhibits healthy activities, leading to an increased BMI?

Answer 21

knee OA

Question 22

what treatment can be used to temporarily decrease pain and inflammation to improve function?

Answer 22

steroid injections

Question 23

how often can steroid injections be used?

Answer 23

3 injections/year

Question 24

what non-op treatment increases viscoelasticity of synovial fluid and can be repeated q 6 months as needed?

Answer 24

hyaluronic acid injections

Question 25

in which patients should hyaluronic acid injections be considered?

Answer 25

failed steroid injections

Question 26

what should patients know when getting a hyaluronic acid injection?

Answer 26

no impact weight bearing activities for 24-48 hrs

Question 27

what non-op treatment is available (but not FDA approved) to help tissue healing by releasing growth factors?

Answer 27

platelet-rich plasma (PRP)

Question 28

what is the operative treatment for OA of the knee?

Answer 28

total knee replacement

Question 29

what can be seen in xray to indicate OA? (4)

Answer 29

joint space narrowing
sclerosis
bone end deformity
osteophytes (bone spurs)