Arthritis 2 - OA

Question 1

epi of OA

Answer 1

75% of all arth

• knee most common leadin to dis
• on the rise

Question 2

3 reasons OA on the rise

Answer 2

1. obesity
2. less activity
3. incr. age of pop

Question 3

2 general patterns of OA

Answer 3

1. localized
   - hand
   - knee
   - hip
2. generalized
   - 3+ joints

Question 4

OA on the spine?

Answer 4

common

• in facet joint
• degen disc disease in lumbar spine

Question 5

what is OA not

Answer 5

• inevitable part of aging

- degenerative disease

Question 6

what is OA

Answer 6

progressive disease of synovial joints from failed repairs of damage reulting from stresses on the joint

Question 7

2 general patterns of pathogenesis

Answer 7

1. abnormal stress on normal physiology

2. normal stress on abnormal physiology

Question 8

what are age related joint diseases

Answer 8

• thinning cart
• less responsive to growth factors
• muscle weakness
• slower reaction times

Question 9

what is sex diff

Answer 9

F 2x as M

• hormones
• body shape
• genes
• social?

Question 10

what does genes determine

Answer 10

50% of hip, hand, general OA

less for knee

Question 11

how does joint load impact

Answer 11

normal joint loading is okay, but when becomes abnormal somehow, then get the problems

Question 12

6 factors that neg. affect the joint load

Answer 12

1. alignment (mal)
2. laxity of knee joint
3. nerve damage
4. joint injury
5. joint deformity
6. neuromusc. function

Question 13

what is obesity related to

Answer 13

knee and hand

• less hip
• stronger relate for women

Question 14

3 possible cont. of obesity

Answer 14

1. malalignment
2. overloading
3. cytokines

Question 15

3 ways to make a diagnosis of OA

Answer 15

1. imaging
2. Sx
3. exam

Question 16

what is seen on x-rays

Answer 16

1. irreg. thickening of subchondral bone
2. thickening and distortion of capsule
3. sysnovitis
4. osteophytes

Question 17

limits of x-ray

Answer 17

detects destruction/loss by inference

- JSN occurs in late phase

Question 18

issues with MRI

Answer 18

very good, but $$$

Question 19

3 possible things that are helpful on MRI

Answer 19

meniscal tears don’t help

• full thickness cart. defects
• bone marrow lesions
• subchondral cortical bone defects

Question 20

4 OA Sx

Answer 20

pain
fatigue
stiffness with rest
functional limitations

Question 21

what is important about pain quality

Answer 21

neuropathic pain may be a sign of central sensitization

Question 22

OA Sx cascade

Answer 22

pain>poor sleep>fatique>depression>worse pain

Question 23

Phx findings in OA

Answer 23

• joint line tenderness
• bone enlargements
• crepitus
• reduced ROM
• inflamm

Question 24

4 issues to getting effective treatments

Answer 24

• societal beleifs
• phys. awareness
• attitudes about pain killers
• co-existant medical probs

Question 25

2 keys to prevention

Answer 25

1. prevent joint injuries | 2. healthy weight mgmt

Question 26

what is treatment ladder from least to most invasive/effective

Answer 26

1. TENS, chondroitin, capsaicin 2. exercise, weight mgmt, insoles, aceto 3. topical NSAIDs, joint injections 4. systemic NSAIDS, opioids 5. joint replacement