Osteoarthritis

Question 1

Explain the changes to cartilage and bone in synovial joints which indicate OA

Answer 1

• loss of cartilage at synovial joints
• accompanied by the degeneration of underlying bone.

Question 2

Typical demographic

Answer 2

positive family history
Women>males (3:1)
>55 years of age

Question 3

The presence of hand OA increases the risk of future hip and knee OA. TRUE/FALSE?

Answer 3

TRUE

Question 4

risk factors for OA

Answer 4

Previous trauma of a joint
Obesity
Hypermobility
Occupation e.g. cotton workers and farmers are more susceptible to hand OA

Question 5

Osteoporosis reduces the risk of OA. TRUE/FALSE?

Answer 5

TRUE

Question 6

What hand joints are more commonly affected in OA?

Answer 6

The carpometacarpal joints (CMCs) and distal interphalangeal joints (DIPJs)

Question 7

how long does morning joint stiffness last for in hand OA?

Answer 7

only a few minutes compared to the morning joint stiffness seen in rheumatoid arthritis.
worse after long periods of inactivity e.g. waking up in the morning

Question 8

what are the names given to the painless nodes (due to osteophyte formation) at PIP and DIP joints in OA?

Answer 8

Heberden’s nodes at the DIP joints
Bouchard’s Nodes at the PIP joints

Question 9

Deformity of the carpometacarpal joint of the thumb resulting in fixed adduction of the thumb in OA. What clinical sign is this?

Answer 9

Squaring of thumb

Question 10

XR findings in OA

Answer 10

L - loss of joint space
O - osteophytes
S - subchondral cysts
S - sclerosis

Question 11

Management of OA

Answer 11

weight loss
topical NSAIDs
oral NSAIDs + PPI
walking aids
intra-articular steroid injections
if conservative methods fail then refer for consideration of joint replacement