What is the most common type of arthritis in the elderly ?
What joints are commonly affected in OA ?
Weight bearing joints: knees, hips and hands (DIPs, PIPs and CMC joints)
What is the mnemonic for the 4 main risk factors ?
1. Obesity, 2. Family history, 3. Female (particularly after menopause) 4.Age
What are the 3 other risk factors for OA ? 😂
- Hyper-mobility 2. Trauma 3. Certain occupations e.g sports
What are the 3 main symptoms of OA ?
- Pain worse on movement/exercise and at the end of the day. If severe may be constant rest pain
- Stiffness after periods of rest lasting < 30mins
- Reduced range of movement
What are 2 biggest RF and 3 Signs for knee OA ? 😭
RFs: 1. Obesity and 2. Previous trauma or Sport injury’s
Signs: 1. Crepitus, 2. Genu varus 3. Reduced range of movement and Muscle wasting
What are 1 biggest RF and 3 Signs for hip OA ? 😭
- Reduced internal and external rotation
- Fixed flexion deformity
- +ve Trendenlenbergs test
What are 3 Signs for hand OA ?
- Bouchard nodes (PIPs)
- Herberden nodes (DIPs)
- Squaring of bade of thumb
What are the 2 types of OA ?
- Erosive 2. Crystal associated OA
What are the x-ray changes in OA ?
LOSS Loss of joint space Osteophyte formation Subchondral sclerosis Subchondral cysts
What investigations will you do for OA ? (Bloods)
Bloods: FBC, ESR, CRP, RF and anti-CCP
Basic imaging: 2 x-ray views usually lateral and AP
Describe the conservative management for OA ? 😭
Lifestyle: lose weight if overweight and exercise
occupational therapy assistance
Physiotherapy: strengthening exercises
Describe the medical management for OA (3) 😭
1st line: PN: oral paracetamol + topical NSAIDs
2nd line: Oral NSAIDs (PPI)+ topical capsaicin)
3rd line: intra-articulat corticosteroid injections
Describe the surgical management for OA (3)
Indication: more severe or loss of function TAR 1. Total replacement arthroplasty 2. Arthrodesis 3. Re-alignment osteotomies (Hip/knee)
What are the complications of OA surgery ?
NLPD: Neurovascular injury Leg length discrepancy Prosthetic infection Dislocation