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Flashcards in Osteoarthritis Deck (16):
1

What is osteoarthritis?

non-inflammatory arthritis
-wear and tear

2

What are the characteristic x-ray changes in osteoarthritis?

L – loss of joint space
O – osteophytes
S - sclerosis
S – subchondral cysts

3

What is the pathogenesis of osteoarthritis?

-loss of cartilage matrix
-fibrillation and attempted repair with osteophyte formation then occurs

4

What is the difference between idiopathic and secondary osteoarthritis?

IDIOPATHIC
Localised – hands, feet, knee, hip and spine. Other joints less commonly affected
Generalised – Involvement of three or more sites

SECONDARY
Previous injury
Rheumatoid arthritis
Genetic elements
Acromegaly
Calcium crystal deposition disease

5

what are some causes of secondary osteoarthritis?



Congenital dislocation of the hip

Perthes

SUFE

Previous intra‐articular fracture

Extra‐articular fracture with malunion

Osteochondral / hyaline cartilage injury

Crystal arthropathy

Inflammatory arthritis (can give rise to mixed pattern arthritis)

Meniscal tears

Genu Varum or Valgum

6

What are the risk factors for osteoarthritis?

Age
Female versus male sex
• Obesity
Occupation
Sports activities
Previous injury
Muscle weakness

7

What are the symptoms of osteoarthritis?

Pain – typically worse on activity and relieved by rest. May progress to be present with less activity and at rest or at night.

Stiffness – usually morning stiffness lasts less than 30 mins. Inactivity gelling. worse after effort. evening stiffness

8

What general examination findings are found in osteoarthritis?

Joint tenderness
Joint effusion
Crepitus
Bony enlargements due to osteophytes

-joints feel hard and bony

9

What is seen in the hands in osteoarthritis?

DIP, PIP and 1st CMC joints
Bony enlargements may be seen at DIPs (Heberdens nodes) and PIPs (Bouchards nodes)
Squaring of the thumb

10

What is seen in the knee with osteoarthritis?

Osteophytes, effusions, crepitus and restriction of movement
Genu varus and valgus deformities
Bakers cyst

11

What is seen in the hip in osteoarthritis?

Pain may be felt in groin or radiating to knee
Pain felt in hip may be radiating from the lower back.
Hip movements restricted

12

What is seen in the spine in osteoarthritis?

Cervical – pain and restriction of movement
Osteophytes may impinge on nerve roots
Lumbar – osteophytes can cause spinal stenosis if encroach on spinal canal

13

What are the non-pharmalogic treatment for osteoarthritis?

Explanation - not because of overuse
Physiotherapy- muscle strengthening, proprioceptive
‘Common sense measures’ - weight loss exercise, trainers, walking stick

14

What are the pharmologic treatment of osteoarthritis?

Analgesia – paracetamol, compound analgesics, topical anagesia

NSAIDs - may give additional symptomatic relief, consider risk/benefit ratio

Pain modulators – tricyclics eg. amitriptyline, anti-convulsants eg. gabapentin

15

What intra-articular therapies exist for osteoarthritis?

Steroids
Hyaluronic acid

16

What surgical therapies exist for osteoarthritis?

Arthroscopic washout, Loose body, soft tissue trimming.
Joint replacement