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MSK II Exam II > Osteoarthritis/DJD > Flashcards

Flashcards in Osteoarthritis/DJD Deck (13)
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1

Most common form of arthritis worldwide

OA

[also leading cause of pain and disability of lower extremity]

2

Risk factors for OA

Aging
Female
Obesity
Occupational risks
Genetics
Trauma/injury

3

OA is characteristically non-inflammatory and without systemic symptoms. The pain is _____ by rest, morning stiffness is brief, and it is oligoarticular

Relieved

4

Pathophysiology of RA involves a combination of multifactorial stressors including the consequences of aging, _______ articular cartilage loss (type II), increasing thickness and _____ of subchondral bone plate, outgrowth of ______ at the joint margin, joint injury, and extracellular matrix degeneration.

Weakness of muscles bridging the joint may also play a role

Hyaline
Sclerosis
Osteophytes

5

Clinical manifestations of OA

Usually weight bearing and frequently used joints

Usually >50 y/o

Insidious onset of intermittent sxs, becomes more persistent and severe over time

Pain worse with activity, relieved by rest

Crepitus, decreased ROM, effusion (cool, not hot)

Heberdens and bouchard nodes

Hip involvement manifests as groin pain

Spondylosis and spinal stenosis

Joint instability

6

What are some potential findings on radiographs of OA?

Asymmetric joint space narrowing

Subchondral sclerosis-thickening

Osteophytes and marginal lipping

Bone cysts

Joint mice (loose particles)

7

Primary OA is the most common type, no identifiable cause is recognized.

What are the most common joints affected in this type?

DIP
PIP
1st carpometacarpal joint
Hip and knee
Cervical spine
Lumbar spine

8

Type of osteoarthritis that affects DIP and PIP joints but is more painful than typical hand OA; more common in women and shows central erosions on radiographs with “seagull” apearance in finger joints

Erosive OA (inflammatory OA)



[note that central erosions are erosive OA, while marginal erosions would indicate RA]

9

Secondary causes of OA

Trauma
Joint infection
Surgical repair (ACL, meniscus, etc)
Congenital joints
Metabolic
Endocrine

10

What joints are typically affected in OA secondary to hemochromatosis?

2nd/3rd MCP joints
Wrist

11

What joints are typically affected in OA secondary to pseudogout?

MCP
Wrist
Knees
Hips
Shoulders

12

What joints are typically affected in OA secondary to hyperparathyroidism?

Wrist
MCP

13

Management of OA

There is no cure or agents approved to prevent/delay/remit the structural progression of OA

Management of pain/disability are key — requires non-pharmacologic and pharmacologic modalities

Non-pharm = education, joint protection, weight loss, proper footwear, isometric-aerobic exercise, strength training, cane

Pharm = NSAIDs, duloxetine, tramadol, acetaminophen, topical capsaicin, steroid injections, total joint replacement surgery