Osteoarthritis

Question 1

Definition

Answer 1

Age-related synovial joint disease

Question 2

Primary

Answer 2

Generalised

Question 3

Secondary

Answer 3

Secondary to other joint diseases, haemochromatosis (iron overload), or obesity

Question 4

Pathogenesis

Answer 4

Can be due to abnormal loading on normal cartilage
Or
Normal loading on abnormal cartilage

Question 5

What percentage of patients >60y/o are symptomatic?

Answer 5

25%

Question 6

Symptoms

Answer 6

Pain

Gelling and stiffness

Question 7

When is the pain worse?

Answer 7

End of the day

Question 8

Signs

Answer 8

Joint tenderness
Heberden’s and Bouchard’s nodes
Crepitus

Question 9

What are Heberden’s nodes?

Answer 9

Bony swellings @ DIP

Question 10

What are Bouchard’s nodes?

Answer 10

Bony swellings @ PIP

Question 11

Joint X-Ray

Answer 11

"LOSS"
Loss of joint space
Osteophyte formation
Subchondral cysts
Subchondral sclerosis

Question 12

What are osteophytes?

Answer 12

Projections from bone

Question 13

What 3 categories can management be split into?

Answer 13

Physical
Pharmacological
Surgical

Question 14

Physical management

Answer 14

Exercise –> to increase local muscle strength
Weight loss
Physiotherapy

Question 15

Pharmacological management pathway

Answer 15

Paracetamol ± topical NSAIDs –> codeine/short-term oral NSAIDs, topical capsaicin –> intra-articular steroid injections –> intra-articular hyaluronic acid injections