Osteoarthritis

Question 1

Definition

Answer 1

Tear - Micro-damage to joint
Flare - Inflammatory response
Repair - Continued response

Question 2

Epidemiology

Answer 2

Most common joint problem

60% of the over 60s

Question 3

Pathophysiology

Answer 3

Synovial hypertrophy 
Subchondral changes (thickening)
Joint effusion

Question 4

Etiology/Risk Factors

Answer 4

Repetitive microtrauma:
Mechanical imbalance (abnormal anatomy)
Interarticular fractures
Ligament rupture 
Meniscal injury 
Occupation
Prescient heavy physical activity
Obesity (increased load & pro inflammatory response)

Question 5

Presentation

Answer 5

45 years old

Activity related joint pain
Possibly a tiny amount of morning related stiffness

Slow deterioration

Question 6

Lab Work Up

Answer 6

.

Question 7

Imagining

Answer 7

X-ray (no changes initially)

Question 8

Complications

Answer 8

Depression

Pain modifying ADLs

Question 9

Differential Diagnosis

Answer 9

RA
Septic arthritis
Malignancy
Gout

Question 10

Treatment

Answer 10

Selfmanagement:

• Weight loss
• Reduction in certain activities
• Muscle strengthening
• Sleep

Analgesics (oral/topical/injections):
Paracetamol
NSAIDs
Capsaicin 
Steroid 
Hyaluronic acid

Thermotherapy
Electrotherapy (strengthen muscles)
Spinting

Surgery:

• All treatments should be tried
• Only for significant pain
• Joint replacement

AVOID:
Acupuncture
Glycosamine
Chondrotin

Question 11

Prognosis

Answer 11

.

Question 12

Histology

Answer 12

.