Flashcards in 6.7. Rheumatology - Osteoarthritis Deck (16):
What is the commonest form of Joint problems?
It affects 50% of the population > 60 years old
What is Osteoarthritis defined as?
Note - This is by Arthritis Research UK
"Tear, Flare and Repair"
1. Tear - Trauma and Mechanical Imbalance
2. Flare - Inflammation and Pain
3. Repair - Repair Process around the Joint
What are the Biomechanical Factors which can affect Osteoarthritis?
1. Abnormal Anatomy - Developmental Dislocation of the Hip (DDH)
2. Intra-Articular Fracture
3. Ligament Rupture
4. Meniscal Injury
5. Occupation - Farmers
6. Persistent Heavy Physical Activity
What are the Inflammatory Factors which are part of Osteoarthritis?
1. Synovial Hypertrophy
2. Subchondral Changes
3. Joint Effusion
What is the pathogenesis of Osteoarthritis?
1. Muscle Weakness / Ligament Injury / Abnormal Anatomy lead to Instability / Malalignment
2. Obesity + Instability / Malalignment leads to an increase load on the Joints
3. An increase load on the Joint can lead to Joint Microtrauma and an Osteoarthritic Joint and Synovitis
What Biochemical Mediators become elevated as a result of Osteoarthritis?
1. IL-1 Beta
How is Osteoarthritis diagnosed, from a History?
1. > 45 years old
2. Activity related Joint pain + morning stiffness which lasts less than 30 minutes (if any)
What symptoms are indicative of the diagnosis not being Osteoarthritis?
2. Prolonged morning-related stiffness
3. Rapid deterioration of Symptoms
4. Hot, Swollen Joint
What is the Differential Diagnosis for Osteoarthritis?
2. Other inflammatory Arthritides
3. Septic Arthritis
Where can Osteoarthritis be managed?
1. Primary Care
2. Secondary Care
What management strategies and options are available for Osteoarthritis?
Note - These are from the NICE Guidlines
1. Person Diagnosed with Osteoarthritis
2. Holistic Approach and Self-Management
3. Core Treatments: Information, Exercise, and Weight Loss
4. Additional Treatment Options:
4. a) Non-Pharmacological Treatments
4. b) Pharmagological Treatments
4. c) Referral for Consideration of Joint Surgery
What are the Aspects of the Holistic Assessment of a Person with Osteoarthritis?
2. Health Beliefs
5. Quality of Sleep
6. Support Network
7. Other Musculoskeletal Pain
8. Attitudes to Exercise
9. Influence of Comorbidity
10. Pain Assessment
What are the Non-Pharamcological treatments of Osteoarthritis?
3. Aids and Devices
4. Manual Therapy
What are the Pharmacological treatments of Osteoarthritis?
1. Oral Analgesia (Paracetamol, NSAID's)
2. Topical Treatments:
2. a) NSAID's
2. b) Capsaicin (Knee, Hand)
When is referral to Surgery indicated in Osteoarthritis?
1. Substantial impact on Quality of Life
2. Refractory to Non-Surgical Treatment
3. Referral Letter