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nuero > OA and treatment > Flashcards

OA and treatment Flashcards

1
Q

what is OA

and what it causes

A

OA is a long-term chronic disease characterized by the deterioration of (articular) cartilage in joints which results in bones rubbing together and creating stiffness, pain, and impaired movement.

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2
Q

does inflammation occur in OA

A

Yes, Degenerative disease of chondral cartilage

Inflammation occurs late in disease cf. rheumatoid

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3
Q

what is the order of progression (very brief summary)

A 
(mechanical stress to then inflammation -> primary OA secondary inflammation)
wear and tear 
degrades articular cartilage 
lose joint space 
then inflammation
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4
Q

compare it to RA

A

inflammation first then wear and tear

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5
Q

endogenous predispositions to OA

A

age
gender
high BMI (educating weight loss key part of conservitive treatment)

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6
Q

external risk factors

A

trauma
overload
(preventing high stress excerises)

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7
Q

what is the function of meniscus cartilage

A

shock absorber

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8
Q

how should the articlar cartilage and the whole joint look like

A

smooth shiny white

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9
Q

what are the main risk factors of OA

A

Age, excess weight/obesity

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10
Q

what are other risk factord

A 
mechanical constraints(intense sport) 
hereditary 
female gender/menopause 
oestrogen defiency 
metabolic syndrome 
cruitate ligament rupture
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11
Q

what portions of teh spine does OA effect

A

lumbar and cervical spine

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12
Q

What joints in teh hand

A

DIP PIP

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13
Q

what main joints effected

A

big joints (knee hip spine and fingers)

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14
Q

if other joint affected like ankle

A

maybe due to other conditions

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15
Q

RA affects ehich joints in teh hands

A

NOT THE DIP PIP

metacarpal phalangeal joints

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16
Q

OA signs/symptoms

A 
Pain is related to use
Pain gets worse during the day
Minimal morning stiffness (<20 min) and after inactivity (gelling)
Range of motion decreases
more stiffnes at the end of the day 
Joint instability 
Bony enlargement
Restricted movement
Crepitus
Variable swelling and/or instability
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17
Q

what is the assessment carried out

A

Look
Feel
Move
Special tests

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18
Q

what can you look fpr

A

alignment of the knee and knee scar indicating kneee surgey

19
Q

what do you feel

A

may have fluid around the joints, so a bubble of fluid that can be moved around

20
Q

what do you move

A

the knee while patinet is lying down

angle of flexion

21
Q

what is the special test

A

anterior draw

22
Q

what is the significance of the test

A

cruitiate ligament not wotking

23
Q

why is that significant

A

can cause artitits by increase in wear and tear

24
Q

what lab/blood test can be doen

A

none

25
Q

what else can you anaylse

A

Cartilage degradation products in serum and joint fluid

26
Q

what changes can be seen in a x ray

A

loss of joint space
sclerosis
osteophytes
sunchondral cyst

27
Q

what is scelrosis

A

Sclerosis- thickening of bone- shown by the white –

28
Q

what is subchondral cyst

A

a fluid-filled space inside a joint that extends from one of the bones that forms the joint.
shown as dark region

29
Q

osteophytes

A

are cartilage-capped bony proliferations (spurs)

30
Q

what is conservative OA manadgement

A 
Weight loss
Analgesics: oral/topical NSAIDS, 
Physiotherapy
Walking aids
Avoidance of exacerbating activity
Injections (steroid/viscosupplementation)
31
Q

what injections can be given

A

Steroids
Lubrication gel
Platelet rich plasma
???stem cells (not a lot of evidence)

32
Q

operations

A 
Operative
Replace (knee/hip)
Realign (knee/big toe)
Excise (toe)
Fuse (big toe)
?arthroscopy if loose bone in joint
Denervate (wrist)
33
Q

what q to ask to distinguish between OA and RA

A

the pain throughout the day
worse or better after movement
one knee both knee

34
Q

what is important to ask if yiu want to do a surgery or injection

A

what med they take to see if their are any blood thinners

35
Q

outline the transition from a meniscal tear to OA

A 
Injury 
meniscal tear 
surgery/removal 
increased pressure 
articular cartilage wear 
loss of joint space 
OA
36
Q

what is seen on the DIP with patients of OA

A

heberdens nodes

37
Q

what about PIP

A

bouchards nodes

38
Q

what are they caused by

A

osteophytes

39
Q

what do patients with hip joint problem present with

A

deep groin pain taht radiates into thhe medial thigh

knee pain

40
Q

steriod treatment

A

Steriord help as an antilinflammaoty for 2/3 months maybe up to a year
But too much steroids can cause adverse side effects like  infection, and actually cause A because inflammation in needed to heal and thus may not heal

41
Q

what is the platelet therapy

A

Blood centrifugated to get platelets
Platelets have lots of anti inflammatory mediators
Injected to the knee
Helping cartilage effects

42
Q

what sort of bones are bouchards and heberedens

A

cortical

43
Q

4 core points of physiotherapy

A

Muscle strength
Conditioning
Proprioception
Massage/muscle stretching

nuero (36 decks)

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