osteoarthritis

Question 1

What is the most common form of arthritis?

Answer 1

Osteoarthritis

Question 2

What is osteoarthritis?

Answer 2

A degenerative joint disease, with theclinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life

Question 3

What joints does osteoarthritis most commonly affect?

Answer 3

Knees

Hips

Small joints of hands

Question 4

Pathologically, what does osteoarthritis cause?

Answer 4

Gross cartilage loss

Morphological damage to other joint tissues

Biochemical changes

Inflammation of the synovium and surrounding joint capsule

Question 5

What happens pathologically during the onset of osteoarthritis?

Answer 5

The collagen matrix becomes more disorganised, and there is a decrease in proteoglycan content within cartilage

Question 6

What is the result of the decrease in proteoglycan contact in early osteoarthritis?

Answer 6

Without the protective effect of proteoglycans, the fibers of the cartilage become susceptible to degradation, and thus exacerbate the degeneration

Question 7

How does the degree of inflammation of the synvoium and surrounding joint capsule compare in osteoarthritis to rheumatoid arthritis?

Answer 7

It is mild in osteoarthritis compared to RA

Question 8

What other structures within the joint can be affected in osteoarthritis?

Answer 8

The ligaments within the joint can become thickened and fibrotic, and the menisci can become damaged and wear away

Question 9

What can form on the outer margins of joints in osteoarthritis?

Answer 9

New bony outgrowths, called osteophytes

Question 10

What has the pain in an osteoarthritis joint been related to?

Answer 10

Thickened synovium and subchondrial bone lesions

Question 11

What are the risk factors for the development of osteoarthritis?

Answer 11

Joint injury, or overusing the joint when it hasn’t had enough time to heal after injury or operation

Joints that are severely damaged by previous or existing conditions, such as rheumatoid arthritis or gout

Age

Family history

Obesity

Question 12

What are the signs and symptoms of localised osteoarthritis?

Answer 12

Pain on movement, worse at end of day

Crepitus

Background pain at rest

Joint felling (stiffness after rest) for up to 30 minutes

Joint instability

Question 13

What are the signs and symptoms of generalised osteoarthritis?

Answer 13

Heberden’s nodes, commonly on DIP joints, thumb carpometacarpal joints, and knees

Joint tenderness or derangement

Bony swelling

Decreased range of movements

Question 14

When can a diagnosis of osteoarthritis be made on a clinical basis alone?

Answer 14

When the patient is;
Age 45 or over
Has activity related joint pain
Has no morning joint stiffness, or joint stiffness that lasts for no longer than 30 minutes

Question 15

What tests may be used in the diagnosis of osteoarthritis?

Answer 15

Further tests aren’t normally necessary, however blood tests and x-rayscan be used to rule out other similar conditions

Question 16

What is meant by a holistic approach to osteoarthritis assessment and management?

Answer 16

When someone is diagnosed with osteoarthritis, you should assess the effect on the person’s quality of life, occupation, mood, relationships, and leisure activity

Question 17

What social factors should be assessed in the holistic approach to osteoarthritis management?

Answer 17

Effect on life, including ADLs, family duties, and hobbies

You should also look at lifestyle expectations

Question 18

What occupational factors should be looked at in the holistic management of osteoarthritis?

Answer 18

Ability to perform job, both in the long term and short term, and any adjustments required to be made to the home or workplace

Question 19

What mood factors should be assessed in the holistic management of osteoarthritis?

Answer 19

Screen for depression, and check for other current stresses in life

Question 20

What should be assessed regarding the support network in the holistic management of osteoarthritis?

Answer 20

Nede to know the ideas, concerns, and expectations of the main carer, and how the carer is coping. Also need to know if the patient is isolated, and how to manage this if so

Question 21

What should be assessed regarding other musculoskeletal pain in the holistic management of osteoarthritis?

Answer 21

Should find out if present, as this might suggest a chronic pain syndrome or another treatable source of pain

Question 22

What should be assessed regarding the influence of co-morbidity in the holistic management of osteoarthritis?

Answer 22

The patient may have an interaction between two or more co-morbidities. This might affect the fitness for surgery, or ability to understand surgical options. It might also alter the assessment of the most appropriate drug therapy, or increase the risk of falls