Osteoarthritis Flashcards Preview

MS/Rheum > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (23):
1

What part of the joint is involved in OA

the entire joint structure:
cartilage, subchondral bone, ligaments, menisci, synovium, and capsule

2

OA is most characterized by

cartilage loss

3

What is responsible for the pain in OP

osteophytes
**also responsible for dec ROM

4

What joints are commonly affected by OA?

Hip
knee
hands
spine
feet

5

what contributes most to disability in OA?

pain and functional limiatations

6

epidemiology of OA

inc with age (due to decreased cellularity of cartilage)
women > men

7

risk factors for OA

age
obesity
female
joint malalignment
trauma (previous surgery, fracture, etc)

also, hypermobility, osteoporosis, congenital joint dysplasia and dislocation, occupation and sport

8

What is the etiology of secondary OA

suboptimal repair of normal cartilage injury due to..

1. Pre-existing joint damage (RA, gout, spondylarthritis, septic arthritis, Paget’s)

2. Metabolic disease (Chondrocalcinosis, Hemochromatosis, Acromegaly)

3. Systemic disease (Hemophilia, Hemaglobinopathies (sickle cell dz))

9

Pathogenesis of OA

mechanical stress --> release of MMPS by chondrocytes --> degradation of collagen and proteoglycans --> pro inflamm cytokines (IL-1 and TNF) are releases + NO --> increased cartilage degradation > production --> chondrocytes sense damage and attempt to repair --> repair is disordered --> hypertrophy of bone at joint margins = osteophytes --> more inflammation --> destructive cycle continues

10

in OA there is increased expression of ____ in chondrocytes

inducible COX 2

11

in OA ____ may contribute to the pain and predict progession of disease and need for joint replacement

bone marrow lesions

12

what does an osteophyte consist of?

fibrocartilage and bone

13

WHere are osteophyts found?

periph of joints at the interface of cartilage and periosteum

14

clinical presentation of OA

symp:
-joint pain
-morning stiffness (short lived
-functional limitations

signs:
-crepitus
-restricted ROM
-bony enlargements/osteophytes

(also, joint effusions, bony instability, muscle atropy)

sometimes will have elevated ESR or CRP

15

treatment goal for OA

Symptom relief, improve quality of life, and prevent progression of disease

16

non pharmacological treatment of OA

weight loss, hot/cold, exercise, orthotics

17

pharmacological treatment of OA

topical capsaicin, NSAID, lidocane
acetaminophen, NSAIDs, narcotics
intra-articular corticosteroids and HA derivatives

18

heberdons nodes vs bouchard's nodes

Hep: osteophytes on DIP
Bouch: PIP

19

early vs late joint changes in RA

early: cartilage surface irregularity and superficial clefts

late: cartilage ulceration that exposes bone

20

bony changes in OA

due to chondocytes sensing damage and attempting to repair it --> they form clusters or cloves and cause...

sclerotic subchondral bone
hypertrophy = osteophytes

21

Early and polyarticular is assc with a mutation in

COL2A1 gene

22

deficiency in ____ is assc with OA

TFG-B and IGF-1

23

_____ gene is assc with an increase in severity of OA

IL-1 receptor agonist gene