Osteoarthritis

Question 1

Define OA

Answer 1

NON-inflammatory arthritis with no systemic symptoms

Question 2

What are a few risk factors for OA?

Answer 2

Age
Obesity
Occupational hazards

Question 3

With the pathophysiology of OA, what is lost?

Answer 3

Thinning/loss of hyaline articular cartilage

Question 4

Describe the type of cartilage that is lost with OA

Answer 4

Type 2 collagen and proteoglycan (aggrecan)

Question 5

After cartilage is lost, what occurs to the bone with OA?

Answer 5

Subchondral bone thickening (sclerosis) and remodeling

Question 6

Mild reactive synovitis can also occur. What results and what mediates it?

Answer 6

Mediated by IL-1b and TNF-alpha

= synovial hypertrophy and effusion

Question 7

What locations are the most commonly affected by OA?

Answer 7

• Cervical and Lumbar spine
• Hips and knees
• 1st CMP (thumb), PIP and DIP joints
• 1st MTP joint

Question 8

What locations are the most commonly affected by OA?

Answer 8

• Cervical and Lumbar spine
• Hips and Knees
• 1st CMC joint (thumb), PIP, DIP
• 1st MTP joint

Question 9

Herbedens Nodes

Answer 9

DIP bony prominences

Question 10

Bouchards Nodes

Answer 10

PIP bony prominences

Question 11

OA affects what type of joints?

Answer 11

Weight bearing

Often used joints

Question 12

What type of onset and progression does OA have?

Answer 12

Insidious onset of intermittent symptoms

–> more persistent and severe as time goes on

Question 13

Describe some symptoms of OA

Answer 13

• Pain worse with activity and relieved by rest
• Crepitus and decreased ROM
• Cool effusion
• Joint instability

Question 14

Laboratory results with OA?

Answer 14

Usually NORMAL

Question 15

How does the joint fluid look with OA?

Answer 15

Clear with good viscosity and WBCs < 2000

Question 16

List 5 things you could see on an OA radiograph

Answer 16

1. Space narrowing
2. Subchondral sclerosis/thickening
3. Osteophytes and marginal lipping
4. Bone cysts
5. Joint mice

Question 17

List 5 things you could see on an OA radiograph

Answer 17

1. Space narrowing
2. Subchondral sclerosis/thickening
3. Osteophytes and marginal lipping
4. Bone cysts
5. Joint mice

Question 18

How does the subchondral sclerosis/thickening look on radiograph?

Answer 18

White

Question 19

What joints are usually affected with Erosive OA?

Answer 19

DIP and PIP

Question 20

Erosive is more common in _____. What symptom is atypical?

Answer 20

More common in women

= More PAIN than typical

Question 21

What sign on radiograph will indicate an Erosive OA?

Answer 21

Seagull appearance

– central erosions!

Question 22

DISH stands for?

Answer 22

Diffuse Idiopathic Skeletal Hyperostosis

Question 23

What is DISH?

Answer 23

Calcification and ossification of spinal ligaments and enthesis (attachments of tendons/ligaments)

Question 24

DISH is more common in who and where?

Answer 24

Men – T spine!

Question 25

Ossifications of at least 4 contiguous vertebral levels on the right side of the spine most commonly is?

Answer 25

DISH | - Diffuse Idiopathic Skeletal Hyperostosis