Osteoarthritis Flashcards
Tell me about osteoarthritis
It is the most common joint condition. Wear and tear
3F:1M
Onset usually >50yrs
It is primary (generalised), or secondary to joint conditions
It is characterized by focal loss articular cartilage with new bone proliferation and remodeling of joint contour
What are the most common joints affected in osteoarthritis
commonly: cartilage of weight baring joints (Knee and hip)
carpometacarpal joint
distal interphalangeal joints (DIP)
proxima interphalangeal joints (PIP)
Symptoms and signs of osteoarthritis
Pain on movement and crepitus
background pain at rest
stiffness after rest for 30 mins
Brief morning stiffness 15-30mins
Reduced range of movement
Mild synovitis
When is osteoarthritis worse
worse at end of day
What to do in the history of suspected OA:
assess affect of disease on
Occupation
Family duties
hobbies
lifestyle expectations
Investigation for osteoarthritis
plain film radiography - loss of joint spaces
bloods maybe normal
Conservative treatment of osteoarthritis
exercise to improve strength of surrounding muscles
Irrespective of age
involve physiotherapy and occupational therapist
Heat or cold packs on site of pain
Medicine treatment of osteoarthritis
long term Analgesia
Paracatemol +- topical NSAIDs
if not working start codeine or short term oral NSAIDs with PPI
Intra-articular steroid injections for severe symptoms
intra-articular hyaluronic injections as effective as above but more expensive
Surgical treatment of osteoarthritis
Joint replacement therapy is the best way to deal with severe OA
Is osteoarthritis usually unilateral or bilateral
Unilateral
Where is PIP
in the hand (knuckle)
Where is DIP
in the hand (most distal joint)
Where is the carpometacarpal joint
it is the joints between the digits and the bones of the hand center
