Lecture 97 - Osteoarthritis Flashcards
T/F – RA is more common than OA
OA is more common; the most common
what is OA
NON INFLAMMTORY
progressive disease representing the failed repair of joint damage
Progressive degeneration of the articular cartilage
EPI of OA:
who gets this
why is there increased mortality?
Risk factors for OA
protective factor for OA
Women > men
Increased Mortality -- CVD -- due to decreased physical activity vs NSAIDs
Risk Factors:
Age, SEx, Bone Mass,
obesity, Previous joint injury, occupational repetivie motions, joint deformities
protective: smoking
what joints are classically effected
what joints are spared?
DIPs > PIPs; Thumb MCP and Carpometacarpal Joint \
L and C spine
first MTP of the Great toe
knees, hips, back and neck
Sparing: 2-5th MCPs (More likely to be RA)
what joints are classically affected by RA – what joints are spared
PIP, MCP, MTP, C1, C2
No DIP involvment
difference in morning stiffness and progression of between RA and OA patietns
RA - morning stiffness > hour; pain improves throughout course of the day
OA - morning stiffness
Pathophysiology of OA:
what can activate a chondrocyte
Insult to the joint
Chondrocytes attempts to repair
Older Persons: senescence of the chondrocyte
Chondrocyte activation – mechanical stress, cytokines, collagen fragemnts
what is seen in the cartilage histologically
Degredation of Zone 1
Duplication of Zone 4
what is a heberden node?
what is a bouchard node?
heb - node of the DIP
bouch – node of the PIP
imaging findings of OA
thinning of joint spcae
Asymmetric
Osteophytes
Relationship of OA and Metabolic Syndrome
ncreased adipokines, subchondral ischemia due to HTN, and increased glycosylation in DM2
treatment of OA
COMBINATION OF PHARM VS NON PHARM TREATMENTS
Non pharm – regular exercise, weight loss, walking aids, approrpiate footwear,
Pharm - Aceaminophoen NSAIDS, IA glucocordicoirs Tramadol Referral for surgery Opiods
