Osteoarthritis Flashcards
(16 cards)
OA involves these aspects of a joint
- cartilage
- synovial membrane
- ligaments
- bone
What is OA
- initiated by micro and macro-injury
- activates maladaptive repair responses
Mechanism of progression of OA
- release of inflammatory enzymes + abnormal biomechanical forces
- damage of cartilage
- cartilage loss
- increased bone turn over and localized density (osteophytes)
Risk factors for OA
- Age
- Sex (women > men)
- Genetic
- Obesity
- Physical Inactivity
- Injury
- Joint stress (occupational)
Race/Ethnicity tendencies?
Maybe?
3 classifications of OA
- Radiographic OA
- Symptomatic OA (clinical)
- MRI-defined OA
Radiographic OA features
L: loss of joint space
O: osteophytes
S: subchondral sclerosis (increased periarticular bone density)
S: subchondral cyst formation (typically hyaluronic acid)
Kellgren-Lawrence Grading System for OA
0: no radiographic features
1: Doubtful: minute osteophyte, doubtful significance
2: minimal: definite osteophyte, unimpaired joint space
3: Moderate: moderate decrease in joint space
4: Severe: joint space greatly impaired with sclerosis of subchondral bone
Clinical features of OA
- Pain after using joint
- relieved by rest
- morning stiffness less than 30 minutes
- Stiffness after period of inactivity
Symptomatic OA joint; 4 questions
- Constant or intermittent pain at any time month/year, worse with activity, relieved with rest?
- Effusion
- Flexion contracture
- Gait abnormality
MRI helps to study the pathogenesis of OA via
- bone marrow edema
- found in acute trauma injuries
- Shows increase in localized blood pooling
First line treatment for OA
- Exercise
- Weight loss
- Acetaminophen
T/F OA is linked to obesity in weight bearing and non-weight bearing joints
T
1 pound of weight lost = a ___ pound weight loss of knee joint load
4
10% decrease in body weight = average of ___% relief of pain
28% decrease in pain
Key takeaways
- OA is not normal aging
- Exercise, weight management, pain meds are effective treatments
- OA can be managed using the step care model
