Osteoarthritis Flashcards Preview

MSK 2 Post Midterm > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (20):
1

Radiologic findings in OA

Presence of osteophytes (marginal spurs), joint space narrowing due to T2 collagen loss, and subchondral sclerosis

2

Characteristic location of osteophytes

DIP (Heberden) and PIP (Bouchard)

3

Define etiology of OA

Progressive deterioration & loss of articular cartilage, leading to loss of normal joint structure & function.
Primary - aging or idiopathic, genetic (nodal OA)
Secondary - due to disorders that damage joint surfaces

4

What is the pathophysiology behind the Etiology #1 of OA - Damage to normal articular cartilage by physical forces

chondrocytes react and release degradative enzymes and inadequate repair response

5

What is the pathophysiology behind the Etiology #2 of OA - fundamental defective cartilage fails under normal joint loading

type 2 collagen gene defect

6

Describe sx of OA

 Insidious onset
 Joint pain associated with movement
 Limitation of motion/ function
 Minimal stiffness after rest
 Referred pain
 Acute flares suggest another diagnosis
 Systemic symptoms are rare

7

common locations of OA

Cervical spine
Lumbar spine
1st CMC
PIP
DIP
Hip (more genetically variable)
Knee
1st MTP

8

Physical Signs of OA

 Bony changes in joint shape
 Crepitus
 Malalignment/Instability
 Limited ROM
 Joint line tenderness
 **Cool effusions (***not hot, warm, effusions - OA is non-inflammatory. Not much pain, just decreased motion.)
 Spasm or atrophy of adjacent muscles

9

Describe cartilage - thickened or thinned - in OA

thinned

10

What happens to subchondral bone in OA?

thickening/sclerossis

11

What happens to chondrocytes

altered function

12

Describe pain with rest/exercise in OA

Pain relieved by rest, morning stiffness brief, articular inflammation minimal.

13

**Describe XR findings

**narrowed joint space, cartilage loss, osteophytes at joint margins, increased density of subchondral
bone, bone cysts

14

Diagnostic tests for OA

none. XR is best.

15

Describe nodal osteoarthritis

Hands -
•Heberden’s Nodes: DIP
•Bouchard’s Nodes: PIP
•1st CMC Joint: base of thumb

16

Describe the most common location of OA

knee

17

What is this?
 exuberant osteophytosis of spine/spans > 3-4 vertebral segments (outside the joint)
 preservation of disc spaces
 ligamentous calcification
 >50 yoa
 M>F
 associated with DM
 Complication: ant. cervical osteophytes - dysphagia

Diffuse idiopathic skeletal hyperostosis (FISH)

"flowing osteophytes" in cervical/thoracic spine

18

tx of OA

no cure. WL and NSAIDs
pain control, enhance health related QoL - wt loss
-SURGERY
-intraarticular steroids
-Physical therapy, conditioning
-glucosamine

19

#q's on test

5

20

what are syndesmophytes?

chondrocytes gone crazy