Osteoarthritis Flashcards
What is Arthritis?
inflammation of a joint
Most common types of arthritis?
osteoarthritis
rheumatoid arthritis
gout
How does Arthritis Affect a Person?
OA is most common type of joint disease in Canada
It is a slowly progressive non-inflammatory disorder of the diarthrodial (synovial) joints.
Symptoms usually start at the age of 50 – 60 years
It is not part of normal aging, but the risk of developing arthritis goes up as a person gets older
Fibrous Joints?
articulating surfaces are joined by fibrous tissue.
The DEGREE OF MOVEMENT depends upon the length of collagen fibers uniting the bones.
e.g. inferior tibio- fibular joint ; sutures of the vault of the skull
Cartilaginous joints: TYPE 1?
the bones are united by a bar plate of hylaine cartilage.
e. g. the union ( of a growing bone) between the epiphysis and diaphysis of a growing bone.;
first rib and the manubrium sternum.
NO MOVEMENT IS POSSIBLE.
Cartilaginous joints: TYPE 2?
the bones are united by a plate of fibrocartilage.
The articular surfaces are covered by a a thin layer of hylaine cartilage .
e. g. intervertebral joints;symohysis pubis .
LIMITED MOVEMENT.
Synovial joints?
The articular surfaces of the bones are covered by a thin layer of hyaline cartilage, separated by a synovial joint cavity .
e.g. knees, hips, elbows, hands, feet.
GREATER DEGREE OF MOVEMENT.
synovial fluid allows joint movement
Etiology of OA
No single cause;
can be idiopathic or triggered by an event (trauma) or condition that damages cartilage in the synovial joint.
Risk factors of OA
Age Obesity Genetics Skeletal deformities Joint injuries Repetitive stress injuries Lack of exercise
Pathophysiology?
The cartilage damage triggers a metabolic response at the level of the chondrocytes( cells that make up cartilage)
Normally smooth, white cartilage becomes yellow and granular, then softer and less elastic
Fissuring and erosion of the articular surfaces are the next steps in the damage
As the central cartilage breaks down, bits and pieces of cartilage float in the synovial space, causing pain and stiffness
Inflammation may occur as phagocytic cells try to rid the joint of these bits of cartilage
As the cartilage becomes thinner, cartilage and bony growth increase at joint margins
The resulting incongruity in joint surfaces creates an uneven distribution of stress across the joint & contributes to a reduction in motion
Clinical Manifestations of joints?
Range from mild discomfort to significant disability;
localized pain and stiffness,
crepitation ( a grating sensation caused by loose particles of cartilage in the joint.
Clinical Manifestations of deformity?
Specific to joint involved- Heberden’s nodes on the hands
Can appear as early as 20-30 years of age, majority at 40
Pain & stiffness- “ Ouch I know it’s going to rain!”
Loss of range of motion- altered gait as in OA of the hip 1 leg shorter than the other.
Radiological findings don’t always correlate with the degree of pain experienced by the patient.
Progression of OA?
No cure for OA
Collaborative care focuses on managing pain and inflammation
Preventing disability
Maintaining and improving joint function THROUGH
Collaborative care
Maintaining and improving joint function THROUGH
Collaborative care?
nutritional and weight management counseling, rest & joint protection therapeutic exercise ( with PT), heat & cold applications Occupational therapy accupuncture nutritional supplements ( glucosamine, chondrotin sulfate), yoga massage therapeutic touch guided imagery
Diagnostic Studies ?
Bone scan Computed tomography (CT) Magnetic resonance imaging (MRI) Radiological studies Blood studies: Synovial fluid analysis
Bone scan?
Injection of a radioactive isotope which is taken up by bone; degree of uptake is related to blood flow
