Osteoarthritis

Question 1

What is the pathology of Osteoarthritis?

Answer 1

Breakdown of joint cartilage exposes the bone underneath.

This causes excessive wearing through friction and degeneration of the bone.

“Tear, flare & repair”

Question 2

Where does osteoarthritis most commonly occur? (4)

Answer 2

DIP Joints

Carpo-metacarpal Joints

Hip Joints

Knee Joints

(but can theoretically effect any joint)

Question 3

What is the aetiology of Osteoarthritis?

Answer 3

F > M (x3)

More common in obese

Onset typically after 50

Affects more than half of the UK population.

Question 4

What are some risk factors for Osteoarthritis? (7)

Answer 4

Joint injury

Age

Abnormal anatomy (i.e. DDH)

Obesity

Family Hx.

Occupation

Persistent heavy physical activity (i.e. secondary arthritis from elite running)

Question 5

What are some joint injuries that can lead to Osteoarthritis> (3)

Answer 5

Intra-articular fracture

Ligament Rupture

Meniscal Injury

Question 6

What biochemical factors are raised as a consequence of Osteoarthritis? (3)

Answer 6

IL-1𝝱,
TNF 𝜶,
MMPs

Question 7

What are some differential diagnoses to Osteoarthritis? (4)

Answer 7

Malignancy
Inflammatory arthritides
Gout
Septic Arthritis

Question 8

What are the symptoms of localised Osteoarthritis? (3)

Answer 8

Joint:

• Pain
• Stiffness (usually after rest)
• Instability

Question 9

What are generalised disease symptoms of Osteoarthritis? (3)

Answer 9

Joint Tenderness
Reduced joint mobility
Bony swellings

Question 10

What are some investigations for Osteoarthritis? (3)

Answer 10

X-Ray / MRI

Bloods (CRP may be elevated)

Good History Taking (lifestyle)

Question 11

What are some things you expect to see on X-Ray or MRI in osteoarthritis? (4)

Answer 11

Loss of Joint space

Osteophytes

Subarticular Sclerosis

Subchondral Cysts

Question 12

What are the 3 diagnostic criterion for Osteoarthritis? (not to be confused with risk factor)

Answer 12

Above 45 y/o AND

Activity-related joint pain AND

No morning stiffness / morning stiffness (that is less than 30 minutes)

Question 13

What are the core treatments for Osteoarthrits? (3)

Answer 13

Weight loss (if obese)

Exercise (to improve core strength and muscle strength)

Information/education

Question 14

What are some pharmacological treatments for Osteoarthritis? (4)

Answer 14

Oral Analgesia (NSAIDs / Paracetamol)

Topical Treatments (NSAIDs & Capsaicin)

Intraarticular Hyaluronic Acid Injections

Intraarticular Steroid Injections

Question 15

What are some non-pharmacological treatments for Osteoarthritis? (5)

Answer 15

Surgery (Only for severe osteoarthritis that has a significant impact on a patient’s life)

Thermotherapy

Electrotherapy

Manual Therapy

Technological Aids (occupational therapist will know)

Question 16

List some MDT members involved in an arthritic patient’s care (6)

Answer 16

GP
Specialists / Consultants
Nurse
Occupational Therapist
Physiotherapists
Orthopaedic Surgeon

Question 17

What is the pathogenesis of Osteoarthritis? (5)

Answer 17

1) Muscle Weakness / Ligament Injury / Abnormal Anatomy / Obesity
2) Leads to Instability / Malalignment
3) Increased load on joint
4) Joint Microtrauma
5) Osteoarthritic Joint / Synovitis