Osteoarthritis Flashcards

1
Q

What is the definition of osteoarthritis?

A

Degeneration of joint cartilage and underlying bone

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2
Q

How common is osteoarthritis?

A

Commonest joint condition

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3
Q

What is the pathophysiology of osteoarthritis?

A
  • Usually primary but may be secondary to other causes
  • Damage to articular cartilage
  • Inflammatory response that affects the cartilage, subchondrial bone, ligaments, menisci, synovium and capsule
  • Balance between cartilage degradation by wear and cartilage production by chondrocytes
  • Cartilage becomes oedematous
  • Focal erosion of cartilage
  • Chrondrocytes die
  • Repair is attempted but disorganised = surface is fibrillated and fissured, abnormal sclerotic subchondral bone and overgrowths (osteophytes)
  • Cartilage ulceration exposes underlying bone to ↑ stress = microfractures and cysts
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4
Q

What are the risk factors/aetiology of osteoarthritis?

A
  • Woman
  • Middle age (around 50 years old and prevalence ↑ with age)
  • Genetics
  • Asians – knee OA more common
  • Obesity
  • Hypermobility
  • Osteoporosis - ↓ risk
  • Trauma
  • Congenital joint dysplasia
  • Occupations – e.g. miners, farmers etc
  • Pre-existing joint damage → secondary OA
  • Metabolic disease e.g. acromegaly, haemochromatosis → secondary OA
  • System diseases e.g. haemophilia, neuropathies
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5
Q

What are the signs/symptoms of osteoarthritis?

A
  • Pain on movement – worse at the end of the day
  • Crepitus – worse at the end of the day
  • Background pain at rest
  • Stiffness of joints after rest for up to 30 mins
  • Joint instability
  • Heberden’s nodes – DIP joints, thumb carpometacarpal joints, knees
  • Joint tenderness
  • Joint derangement
  • ↓ range of movement of joint
  • Mild synovitis
  • Valgus/varus leg deformity
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6
Q

What investigations are needed to diagnose osteoarthritis?

A
  • X ray shows: Loss of joint space, Osteophytes, Subarticular sclerosis, Subchondral cysts (LOSS)
  • ↑ CRP
  • Arthroscopy
  • Aspiration of synovial fluid
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7
Q

What are the surgical treatments for osteoarthritis?

A
  • Intra-articular steroid injections

* Joint replacement

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8
Q

What are the pharmacological treatments for osteoarthritis?

A
  • Paracetamol/codeine

* NSAIDs

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9
Q

What are the non pharmacological treatments for osteoarthritis?

A
  • Exercises to improve muscle strength/fitness
  • Walking stick for contralateral side
  • Weight loss
  • Glucosamine and chondroitin
  • Cold/heat therapy
  • TENS
  • Acupuncture – for knee
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