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Flashcards in Osteoarthritis Deck (29):
1

What is Osteoarthritis ?

Articular cartilage failure
Subchondral sclerosis
loss of joint space
Subchondral cyst formation

2

What happens in OA?

Loss of matrix
release of cytokines including IL-1 and TNF
Release of metalloproteinases and prostaglandins by chondrocytes

3

What accompanies fibrillation of the cartilage surface?

Attempts of repair and osteophyte formation

4

What is a clinical presentation of OA?

Pain, typically on activity and relieved by rest.
stiffness usually in the morning (lasts less than 30 mins)
Inactivity gelling

5

What is found on examination with OA?

Crepitus
Bony enlargements due to osteophytes
Joint tenderness
Joint effusion

6

What joints are involved with OA?

Hands
Dip, PIP, and 1st CMC joints
knee
Hip
Spine

7

What kind of deformities are found in the knee?

Genu varus (away from midline)
Valgus (to the midline)

8

What else can occur in the knee with OA?

Bakers cyst

9

Where is pain felt in OA of the hip?

In the groin and radiating to the knee.
May be radiating from the lower back

10

What can occur at the lumbar spine?

Spinal stenosis caused by osteophytes when encroached on spinal canal

11

What radiological signs can show OA?

Loss of joint space
Subchondral sclerosis
Subchondral cysts
Osteophytes

12

In OA, what grading scale is uses?

The Kellgren-Lawrence Radiographic scale of OA

13

How is OA managed?

Physiotherapy
Common sense e.g. weight loss

14

What drugs can be used to treat OA?

Analgesia
NSAID's
Pain modulators

15

What can be done in surgery to help with OA?

Arthroscopic washout, loose body, soft tissue trimming
Joint replacement

16

What is Gout?

Inflammation in the joint triggered by uric acid crystals

17

What is chronic tophaceous gout?

Chronic joint pain, often associated with diuretics.
High serum uric acid
Tophi, may get acute attacks

18

What investigations may you do for suspected gout?

Serum uric acid levels
Inflammatory markers
polarised microscopy of synovial fluid
X-rays
Renal checks

19

What are treatments for Gout?

NSAIDs
Colchicine
Steroids

20

What prophylaxis treatment can you give?

Allopurinol
Febuxostat

21

What does chondrocalcinosis affect?

Fibrocartilage in the knees, wrists and ankles

22

What is chondrocalcinosis, aka CPPD?

Calcium Pyrophosphate Deposition Disease

23

What causes CPPD?

Pseudogout, calcium pyrophosphate crystals

24

What are treatments for CPPD?

NSAIDs
Colchone
Steroids
Rehydration

25

Hydroxyapatite is also known as what?

Milwaukee shoulder

26

What is Hydroxyapatite?

Hydroxyapatite crystals in or around the joint

27

What is released in Hydroxyapatite?

Collagenases, serine proteinases and IL-1

28

What is the treatment for Hydroxyapatite?

NSAIDs
Intra-articular steroid injection
Physiotherapy
Partial or total arthroplasty.

29

What is Anti-Jo 1 associated with?

Polymyositis