Arthritis

Question 1

Osteoarthritis

Which joints tend to be affected?

Clinical features

Answer 1

Distal interpharyngeal joints (DIP) and Proximal interpharyngeal joints (PIP), carpometacarpal joint and large weight- bearing joints (knee, hip)

Pain that arises after use and improves with rest

Unilateral symptoms

Mechanical: instability, locking

Question 2

Osteoarthritis

X-ray findings

Answer 2

Need to ask for a weight bearing AP knee x ray

Loss of joint space

Subchondral cysts and subchondral sclerosis

Osteophytes forming in the joint margin

Question 3

Rheumatoid Arthritis

Clinical Features

Answer 3

Morning stiffness

Improves with use

Bilateral symptoms

Systemic symptoms

Question 4

Rheumatoid Arthritis

Which joints tend to be affected?

Answer 4

Metacarpal-pharyngeal joints (MCP) [knuckles] and Proximal interpharyngeal joints (PIP)

Question 5

Rheumatoid Arthritis

X-ray findings

Answer 5

Loss of joint space

Periarticular erosions

Juxta-articulation osteoporosis

Subluxation

Question 6

Osteoarthritis management

Answer 6

MDT approach with GP, OT, PT: weight loss, unloading brace and improve muscle strength

Medical: analgesia according to WhO ladder with PPI for NSAIDS

Surgery: knee replacements

• total
• unicompartment
• patellofemoral