Osteoarthritis and osteoporosis

Question 1

what are the predisposing factors of osteoarthritis?

Answer 1

• AGE
• INJURY- wearing away of cARTILAGE
• TOO MUCH activity- put stress on it
• obesity

Question 2

why is that patients with osteoarthritis may be ecperiencing more pain now than before at baseline

Answer 2

acute exercabation

Question 3

what are the characteristics of osteoarthrits seen in joints

Answer 3

Degeneration with secondary inflammation

cyst formation- dark fluid formed

Question 4

what are the diagnositc tests needed when suspecting patient with ostearthritis?

Answer 4

• Standing X-ray; to see joint space
• MRI - to look at cruciate ligament
• blood test- to exclude secondary causes and Rheumatoid arthritis

Question 5

what are the key findings of Osteoarthritis seen on X-ray?

Answer 5

• Osteophyte formation
• Subchondoral sclerosis
• Bone erosion
• subchondoral cyst
• reduced joint space narrowing

Question 6

what are the 3 types of management of osteoarthritis?

Answer 6

1. conservative
2. Medical
3. Surgical

Question 7

How can Osteoarthritis develop form injury?

Answer 7

Question 8

what type of collagen is in fibrocartilage, bone and hyaline cartilage

Answer 8

Fibrocartilage- Type 1

Hyaline cartilage- Type 2

bone- 90% type 1

Question 9

what is the pathogenesis of osteoarthritis?

Answer 9

• physical wear of bone and secondary inflammation
• progressive loss of articular cartilage and remodelling of underlying bone
• release of enzymes which break down collagen and proteoglycan
• leads to exposure of underlying bone and sclerosis, osteophyte, and subchondral bone cysts
• progressive joint space loss.

Question 10

What are the primary/idiopathic causes of OA?

Answer 10

• female,
• advancing age
• manual labour
• sports people
• obesity

Question 11

what are the secondary causesof OA?

Answer 11

• TRAUMA
• surgery/removal of fibrocartilage
• infection or inflammatory disease
• Connective tissue disease

Question 12

what are the signs and symptoms of OA?

Answer 12

• Gradual onset
• Joint pain& stiffness & swelling
• Worsen at the end of day with activity
• relieved by rest
• deformtiy (Varus/valgus)

Question 13

compare OA with RA? In joint images

Answer 13

Question 14

what is osteoporosis?

Answer 14

Loss of bone mass and density which leads to weak bones

more porous trabeculae

Question 15

what is osteomalacia?

Answer 15

Softening of bones caused by Vitamin D deficiency; loss of calcification mineralisation.

Question 16

How would you diagnose osteoporosis and distinguish it from osteomalacia?

Answer 16

Use DEXA scan

osteoporosis- T score is lower than -2.5

Osteomalacia- T score is between -1 and -2.4

Question 17

what are the possible causes of Osteoporosis?

Answer 17

• Hypogonadism in men and women
• alchol
• smoking
• cushings syndrome
• GH disorder
• hyperthyroidism
• antiepileptic drugs
• high PTH

Question 18

what are the signs and symptoms of osteoporosis?

Answer 18

• Kyphosis
• high risk of fractures