Osteoarthritis

Question 1

Definition

Answer 1

Disorder of synovial joints characterised by:
-focal damage to articular cartilage
-remodelling of underlying bone and formation fo osteophytes at joint margins.
-mild synovitis.
Progressive joint disease. Failed repair of damage. Intra articular stress initiated by eg abnormal, cartilage, subchondral bone, ligament, menisci, periarticular muscle, peripheral N, or synovium.
Results in breakdown of cartilage and bone.

Question 2

Symptoms

Answer 2

Pain- worse on movement and at end of day. Background pain at rest. 
Stiffness and instability at joints. 
Swelling
Deformity 
Functional disability
Fatigue
Sleep disturbance

Question 3

Signs

Answer 3

Generalised disease- heberdens nodes common at DIP, CMC, knee. 
Synovitis
Reduced range movement 
- XR (LOSS vs RA LESS)
Loss joint space
Osteohpytes
Subarticular sclerosis
Subchondral cyst.

Question 4

Aetiology

Answer 4

Primary or idiopathic.
Secondary- 
trauma
mechanical abnormality
congential disorder
Inflammatory arthritis
Crystal deposition
Metabolic disorders
Pagets
Osteonecrosis

Question 5

Differential

Answer 5

Bursitis, tendinitis
Inflammatory arthritides
Infectious arthritis
Crystal arthropathies eg gout, pseudogout. 
RA

Question 6

Management

Answer 6

Physio
Joint protection, assistive, splint, thermal.
Nutrition
RICE
Weight loss
Analgesia
Steroid and hyaluronic acid joint injections
Arhtrocentesis
Joint replacement, arthroscopy, ostetomies, athrodesis, athroplasty.

Question 7

Explanation

Answer 7

• OA is caused when there is damage to the cartilage that lines lots of our joints. Cartilage usually makes it easy for bones to slide smoothly over each other when we move a joint, and also provides cushioning of impacts. It can just be because of wear and tear, or previous damage.
• the loss of cartilage causes uneven strain around the joint which means bits of bone form in the joint and lead to pain and inflammation and further damage.
• lifestyle tx involves nutrition, weight loss, resting, icing, and elevating the joint when possible. Also physio and exercise plans.
• medical tx pain relief, splints or supportive strapping. Steroids. Sometimes dariang the joint. Eventually joint replacement if not well managed.