Osteoarthritis

Question 1

Define Osteoarthritis

Answer 1

Tear, flare and repair

Degenerative arthritis affecting synovial joints

Question 2

How does osteoarthritis develop

Answer 2

There is trauma or mechanical imbalance,
Which causes inflammation and pain,
There is then repair processes around the joint

Question 3

Bio mechanical factors that can causes Osteoarthritis

Answer 3

Abnormal anatomy, 
Intra-articular fracture, 
Ligament rupture, 
Meniscal injury,
Occupation- farmers, football players,
Persistent heavy physical activity, 
Elite running, 
Obesity

Question 4

In osteoarthritis inflammation occurs, what is occurring at a pathological level?

Answer 4

Synovial hypertrophy,
Subchondral changes,
Joint effusion

Question 5

Presentation of osteoarthritis

Answer 5

Pain and crepitus on movement, with background ache at rest,
Feel unstable,
May be stiff after rest, lasting 10-15 minutes,
Joint tenderness

Question 6

What is seen on a radiograph in Osteoarthrits

Answer 6

Loss of joint space,
Osteophytes,
Subarticular sclerosis,
Subchondral cysts

Question 7

Differential diagnosis with osteoarthritis?

Answer 7

Gout,
Other inflammatory arthritides,
Septic arthritis,
Malignancy

Question 8

Investigation for Osteoarthritis

Answer 8

Xray,
Maybe CRP (may be elevated)

Question 9

Non-pharmacological treatments on OA?

Answer 9

Thermotherapy,
Electrotherapy,
Aids and devices,
Manual therapy

Question 10

Pharmacological treatments of OA?

Answer 10

Oral analgesia,
Topical treatments (NSAIDs, capsaicin (on knees and hand),
Intra-articular injections: steroid,
Intra-articular hyaluronic acid (not approved by NICE guidelines)

Question 11

When should you refer a patient with OA for surgery?

Answer 11

If has had a substantial impact on quality of life,

Refractory to non-surgical treatment

Question 12

Surgery treatment for OA?

Answer 12

Joint replacement surgery

Question 13

You should assess effect of OA symptoms on….

Answer 13

Occupation,
Family duties,
Hobbies,
Lifestyle expectations