Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

“Osteoarthritis is a disease of (moveable) synovial joints which is characterised by loss of articular/hyalin cartilage and resulting overgrowth of the underlying
bone

Question 2

What causes oesteoarthritis?

Answer 2

Not a single cause
* Trauma (eg joint injury)
* Age-related wear & tear
* Structural weaknesses
* Repetitive use (more wear and tear)
* Muscular elements eg muscles not pulling in the right direction
* Congenital influences eg non symmetrical bodies
* Hereditary and ethnic groups

Can be affected by
* Endocrine /hormonal
* Infections eg joint infection as a child
* Crystal depositions leading to wear and tear
* Metabolic disorders eg diabetes
* Diet & obesity
* Lifestyle eg lack of exercise

Question 3

What are the signs and symptoms of osteoarthritis?

Answer 3

Signs & Symptoms
* Pain - mild to severe
* Wear and tear of wt-bearing joints eg hips, knees, ankles
* Stiffness & reduced ROM; capsule around the joint becomes stiffer
* Crepitations - tiny cracks appear leading to clicking/ grating sounds
* Deformities - joints become deformed
* Osteophytes - bony protrusions deposited around the margins of joint, as an attempt of the body to fix things
* Heberden nodes - protrusions of the joint margins around the fingers
* Local effusion - build up of synovial fluid within the joint
* Decreased joint mobility
* Affects DIJs

Can lead to complications
* Septic-arthritis - effusion/fluid in the joints lead to this
* Loose bodies - fragments of cartiledge break off and cause pain and more wear and tear. Can lead to locking of the joint
* Avascular necrosis - death of tissue due to lack of blood flow eg head of hip degenerates
* Crystal synovitis - tiny crystals embedded which cause irritation
* Psychological implications - mental impact of pain etc
* Osteoporosis & fractures - tend to do less activities and more likely to develop bone weakness

Question 4

What is typical diagnotic tests and treatment options for oesteoarthritis?

Answer 4

• Physical assessment is often sufficient but also can carry out:
• Radiography: X-rays, MRIs, CTs, Ultrasound
• Blood tests (to exclude inflammatory conditions)
• Joint fluid aspiration & analysis

Early OA management/ treatment:
* Pain relief
* Improvement of joint mobility (physical therapy) eg pilates, yoga etc
* Load reduction eg weight loss

Intermediate OA:
* Realignment osteotomy for younger patients

Late OA:
* Radical surgery - eg hip replacement
* Arthroplasty