Osteoarthritis Day 1 Flashcards
(52 cards)
What are the risk factors of Osteoarthritis?
Age, Obesity, Occupation, sports, trauma, genetics
What is the pathophysiology of Osteoarthritis?
it is inflammation of the joint
it is characterized by damage to the joint and surrounding cartilage
it can be primary or secondary
What are the 3 types of sites of osteoarthritis?
localized (1-2 sites)
generalized (3 or more sites)
erosive (erosion and proliferation)
What is Normal cartilage?
It is a protective, highly compressible surface covering bone. It enables smooth joint movement, distributes the load, absorbs shock and promotes stability. The nutrient supply is provided through synovial fluid which increases movement
What are chondrocytes?
only cell in cartilage. They repair and restore cartilage. They regulate the extracellular matrix. They control hemostasis of the cartilage. It synthesizes collage, proteoglycan. It secretes enzymes which break down cartilage
What happens when there is damage to the cartilage?
increased chondrocyte activity in the attempt to repair. There is an imbalance of cartilage breakdown and chondrocytes. There is cartilage loss which causes joint space narrowing and this causes deformities and pain
What happens when there is eburnarion?
cartilage is eroded that causes subchondral bone becomes dense and smooth. it causes brittle bones
What forms to help stabilize joints?
osteophytes and this causes inflammation
How do you diagnose Osteoarthritis?
clinical presentation, physical exam, can use radiographic findings and lab values
What is the clinical presentation of Osteoarthritis?
in older patients, the symptoms are typically in the hands, feet, knees, hips and spine
What are the symptoms of osteoarthritis?
deep, aching pain with motion, with rest later in disease
stiffness in joints: morning stiffness <30 minutes that resolves with movement
limited joint movement
instability of weight bearing joints
often related to weather
What do you look for in osteoarthritis?
may involve 1 or more joints assymetrical involvement tenderness on palpatations bony enlargment crepitus limited range of motion MILD inflamation may be present
What do you look for in a physical exam in the hands?
Herbeden’s nodes and Bouchard’s nodes
What do you look for in a physical exam in the knees?
pain with climbing stairs and genu varum (bow-leg)
What do you look for in a physical exam in the hips?
groin pain during wt. bearing activities
stiffness
limited joint motion
What do you look for in a physical exam in the spine?
L3 and L4 are most commonly involved
nerve root compression: radicular pain, parasenthesis, loss of reflexes
What do you look for in a physical exam in the feet?
typically in 1st metatarsophalangeal joints
What are the radiologic findings in osteoarthritis?
often absent in early or mild
Progressive OA: joint space narrowing, subchondral bone sclerosis, marginal osteophytes
Late OA: abnormal joint alignment and effusions
Is there a cure for asteoarthritis?
No
What are the treatment goals of osteoarthritis?
educate patient and caregiver relieve pain and stiffness maintain/improve joint mobility reduce functional limitations maintain/improve QOL
What is the non- pharmologic treatment of osteoarthrits?
patient education
wt. reducation
exercise(walking, stretching and strength training)
physical therapy
assisstive devices
patellar taping, neoprene sleeve, fitted knee brace, heat, wedged shoe insoles
What are the pharmologic recommendations for OA?
Acetominophen Topical agents NSAIDS Tramadol Opiods Intraarticular injections Duloxitine Glucosamine/chondrotin
What therapy agent is typically first line?
Acetominophen
What is the MOA of acetaminophen?
inhibits prostaglandin synthesis in the CNS
