Osteoarthritis

Question 1

Describe the pathogenesis of osteoarthritis

Answer 1

• Initiation
  
  • External factors - age, predisposition, female gender, obesity, trauma
  • Internal factors - muscle weakness, joint misalignment
• Progression
  
  • Damage stimulates chondrocyte proliferation, Il-1 release, enzyme action, matrix depletion
  • Cartilage matrix unravels, loses normal function, enzymes are released
  • Underlying bone is damaged, reflexively thickens
  • Cartilage is shed and eroded (fibrillation)
  • Bone-on-bone contact leads to eburnation (thickening, whitening), cysts, osteophytes.

Question 2

What are the risk factors for osteoarthritis?

Answer 2

• Age
• Female gender
• Obesity
• Genetic predisposition
• Physical occupation
• Knee malalignment

Question 3

What signs and symptoms are likely to be found in someone with osteoarthritis?

Answer 3

• Pain
  
  • Weight-bearing joints
  • Asymmetrical
  • Post-activity
• Giving way/locking
• Active and passive ROM reduction
• Tenderness over joint line
• Crepitus

Question 4

How is osteoarthritis diagnosed? How is it treated?

Answer 4

• Xray
• Pain pyramid
• Medical management
  
  • Physio/OT
  • Intra-articular corticosteroid injections
• Surgical management