OA vs RA

Question 1

What is the most common form of arthritis?

Answer 1

Osteoarthritis

Question 2

What is the cause of osteoarthritis?

Answer 2

No single cause;

• biomechanical
• genetic
• metabolic factors (play a role)

Question 3

Who are the most common people affected by OA? What increases the risk?

Answer 3

• Women over 45

- Increases with age

Question 4

What are the risk factors associated with OA?

Answer 4

• Obesity
• Overuse of joint
• Infection
• Trauma

Question 5

What happens with OA? What is the affected tissue made up of?

Answer 5

• Affects articular cartilage that surrounds subchondral bone
• The cartilage is type II collagen, chondrocytes, and proteoglycans

Question 6

What and why is the tissue affected in a pt with OA?

Answer 6

The cartilage matrix is affected by…

• decreased synthesis and
• increased catabolism

Question 7

How does OA damage the tissues associated with it?

Answer 7

• Damages cartilage
• Makes cartilage thinner
• Decreases proteoglycans

Question 8

Where is OA most common?

Answer 8

• Weight bearing joints

- Hands

Question 9

In OA, what are Bouchard’s and Herbeden’s nodes?

Answer 9

• enlargement of the proximal interphalangeal joints (PIP’s)

- enlargement of the distal interphalangeal joints (DIP’s) of the fingers

Question 10

What are 5 characteristics associated with OA?

Answer 10

• Pain with activity that decreases with rest
• Morning stiffness
• Joint locking
• Crepitus (crunchy)
• Effusion (painful, little articular cartilage)

Question 11

What can X Rays show with OA? What defects present with OA?

Answer 11

• Cyst and subchondral bone sclerosis

- Osteophytes (spurs and joint space narrowing)

Question 12

Since there is no cure for OA what should we know in OA management?

Answer 12

• Takes steps to slow progression
• Assist in symptom management
• Every lb of BW increases forces at knee 2-3 lbs every single leg stance

Question 13

In OA management we must understand that every pound of BW _____ forces on the _____ by ______ pounds every ______ ______ _____.

Answer 13

Increases; knee; 2-3; single leg stance

Question 14

What is a good way to prevent or reduce progression OA (4)?

Answer 14

• Lose weight
• Vitamin D and calcium increase
• minimize immobilization to minimize cartilage damage
• Exercise in open chain to avoid shearing forces

Question 15

What is the second most common form of arthritis?

Answer 15

Rheumatoid Arthritis (RA)

Question 16

Which arthritis is the most disabling OA or RA?

Answer 16

Both are equally as disabling

Question 17

Who are the most common people affected by RA? What is the worst outcome of RA?

Answer 17

• More common in women
• 20-40 years old
• Can lead to death

Question 18

What is the possible cause of rheumatoid arthritis?

Answer 18

Genetic or environmental trigger

- bacteria / virus infection

Question 19

How does RA damage the tissues associated with it?

Answer 19

• Attacks synovial lining which expands

- Damages the extra cellular matrix, collagen, and bone

Question 20

What are early signs of RA?

Answer 20

• Fatigue
• Weight loss
• Fever
• MS pain
• Tenderness, swelling, redness, and stiffness in specific joints

Question 21

When wrist,digits, or toes are affected in RA, what are the signs/deformities?

Answer 21

• Ulnar Deviation
• MCP ; swelling, volar subluxation
• PIP Swan Neck; Hyperextension of PIP, Flexion of DIP
• Boutonnière: Flex of PIP, Ext of DIP
• Toe Hallux Valgus (. bunion)
• Hammer Toes

Question 22

RA has unique Rhuematoid _____ which occur where (3)?

Answer 22

Nodules

• bony prominences
• extensor surfaces
• press points