Osteoarthritis Flashcards
What % of people have radiographic features of osteoarthritis by age 40 / why should this not surprise you? / M or F more often?
90% / Osteoarthritis is the most common form of joint disease / women
Definition of osteoarthritis:
Degeneration of cartilage and by hypertrophy of bone at articular margins
Primary vs Secondary DJD
Primary = hereditary (PIP, DIP), Secondary = secondary to trauma or other illness (RA)
Activity risk factors?
Running is not / contact sports are
Onset / Pain is ________ with activity and ______ with rest:
Insidious - Starts with articular stiffness lasting no more than 15 minutes / Worsened, Relieved
Which joints tend do be involved / lesions on these joints / which joints are spared
Bouchards over PIP, Heberdens over DIP / Spared = MCPs except thumb & Wrist
Lab changes with Osteoarthritis:
Osteoarthritis does not change ESR, SED, no inflammation of synovial fluid
Radiographs show:
Joint space narrowing, osteophyte formation, lipping of marginal bone, thickened subchondral bone, bone cysts may be present
Rheumatoid arthritis affects ______ / Spares _______
MCPs, wrists / DIPs
Non pharm treatment:
Wt loss, Vit D, correct leg length discrepancy, assistive devices for hands, splinting for thumb involvement
First line medication / Second line medication; which is more effective & which is more toxic
Acetaminophen / NSAIDs; NSAIDs / NSAIDs
MOA of NSAIDs
Inhibit COX1 and COX2 pathways which turn arachidonic acid to prostaglandins.
Prostaglandins are involved in:
Inflammation / GI heahlth
Only COX 2 inhibitor;
Celecoxib
Most common side effects of NSAIDs / what increases likelihood of side effects?
GI toxicity, gastric ulceration, perforation, GI hemorrhage / long term use
