Osteoarthritis Flashcards
(17 cards)
What is osteoarthritis?
“Wear and tear” of joints - an imbalance between damage and repair of cartilage causing inflammation of joints
What are the four definitive features of OA that can be seen on Xray?
L – loss of joint space
O – osteophytes
S – sclerosis
S – subchondral cysts
What are osteophytes and how are they formed in OA?
Osteophytes are bony projections that form along joint margins
Formation occurs when broken cartilage is repaired incorrectly
What are some of the predisposing factors that contribute to development of OA?
Obesity Mechanical injuries High impact sports Inflammatory arthritis Female
What are the sites most commonly affected by OA?
Hands, knees, hips
Which joints in the hands tend to be affected by OA?
DIP, PIP and 1st CMC joints
What are baker’s cysts?
Swelling and fluid collection in the back of the knee
What is the clinical presentation of OA?
Pain which is worse on activity and relieved by rest, stiffness
Where might pain in the hip caused by OA radiate to?
Groin
Knee
Where might pain in the hip be referred from?
Lower back
How might spinal sclerosis in OA present and why does this happen?
Pain in hips and upper thighs in a pattern similar to intermittent claudication
Due to nerve impingement
What are Heberden’s nodes?
Hard or bony swellings that can develop in the distal interphalangeal joints in OA
What would be found in a joint affected by OA on examination?
Joint feels hard/bony and cool Joint tenderness Joint effusion Crepitus Bony enlargements due to osteophytes
What is the pathogenesis of OA?
There is loss of the matrix formed by chondrocytes in the cartilage, and release of cytokines (IL1, TNF) from the chondrocytes instead
What causes spinal stenosis?
Osteophyte formation on the lumbar spine encroaching on the spinal canal
What are some of the non-pharmacological treatments of OA?
Explanation - not because of overuse
Physiotherapy- muscle strengthening, proprioceptive
‘Common sense measures’ - weight loss exercise, trainers, walking stick
What are some of the pharmacological treatments of OA?
Analgesia – paracetamol, compound analgesics, topical anagesia
NSAIDs - may give additional symptomatic relief, consider risk/benefit ratio
Pain modulators – tricyclics eg. amitriptyline, anti-convulsants eg. gabapentin
