Osteoarthritis, crystal arthritis and soft tissue rheumatism Flashcards
(52 cards)
What is oseoarthritis?
Articular cartilage thinning or loss
What are some risk factors for cartilage loss?
Age Female Obesity Previous injury Muscle weakness Acromegaly Joint inflammation Crystal deposition
What is an osteophyte?
A bony projection associated with the degeneration of cartilage at joints
What are the different types of oestoarthritis?
Idiopathic
Secondary: previous injry, calcium crystal deposition, rheumatoid arthritis
What joints are likely to be affected by osteoarthritis?
Weight bearing joints: hips, knees, lumbar spie
Joints used alot: cervical spine, thumb
How will osteoarthritis present?
Pain - typically worse on activity and relived by rest. May progress to be present with less activity and at rest/night
Stiffness - morning stiffness that lasts less than 30mins
What can be seen on examintation of oestoarthritis?
Crepitus
Joint swelling
Joint tenderness
Joint effusion - late presentation
Where can oesoarthritis affect in the hands?
DIP, PIP and 1st CMC joints
What is heberdens nodes?
DIP bony enlargements
What is bouchards nodes?
PIP bony enlargement
What can occur in oesteoarthritis of the knee?
Oseophytes Effusions Crepitus Restriction of movement Genu varus and valgus Bakers cyst
Where can pain be felt in hip osteoarthritis?
Groin or referered to knee or lower back
What effect will oestoearthritis of the cervical spine have?
Pain and restiction of neck movement
What effects can spinal osteophytes have?
Spinal stenosis
Pinching of nerve root
What are the radiological findings of osteoarthritis?
LOSS Loss of joint space Osteophytes Subchondral sclerosis Subchondral cysts
What grading scale is used for oestoarthritis?
Grade 0: no radiographic findings of osteoarthritis
Grade 4: definite osteophytes with severe joint space narrowing and subchondral sclerosis
What is osteosclerosis?
Abnormal hardening of bone and elevation of bone density
What are the non-pharma managements of osteoarthritis?
Explanation
Physiotherapy to strengthen muscles
Common sense measures; weight loss, exercise, trainers, walking stick, insoles
What are the pharma managements of oesteoarthritis?
Analgeisa; paracetamol, topical analgesia
NSAIDs. topical or systemic
Pain modulators; tricyclics e.g. amitryptiline, anti-convulsants e.g. gabapentin
Intra-articular; steroids
What are the surgical managements of osteoarthritis?
Joint replacement is the onyl definitve treatment for osteoarthritis
What is gout?
Inflammation in the joint triggered by uric acid crystals
What levels of uric acid in the blood cause gout?
> 0.42 mmol/l is considered hyperuricaemia
What can cause an increased urate production?
Inherited enzyme defects Psoriasis Haemolytic disorders Alcohol (beer/ spirits) High dietary purine intake
What can cause reduced urate excretion?
Chronic renal impairement Volume depletion e.g. heart fialure Hypothyrodism Diuretics Cytotoxics e.g. cyclosporin
