Osteoarthritis OA Flashcards
What is OA?
- An non-inflammatory, degenerative condition of the joints.
- Degeneration of articular cartilage and formation of new bone
2.metabolic, biochemical and structural changes in the articular cartilage,leads to structural failure and ulceration of the load bearing articular surface
Common in weigth-bearing joint such as hip and knees
Prevalance and Epidemology of OA
More common in older females that are > 50, particulary in post menopause as no longer produces estrogen.
Most common joint disease in world.
majority people it affects are over 65.
Causes of OA?
Interplay of multiple factors:
1. joint integrity
2. genetic predisposition
3. local inflammation
4. mechanical forces (weight-bearing)
5. cellular and biochemical processes
What are the risk factors of OA?
- Obesity
- Abnormal mechanical loading e.g. meniscectomy
- Inherited type II collagen defects in premature polyarticular OA
- Inheritance in Nodal OA
- Occupation e.g. Farmers
- Infection
- Poor posture
- Aging process in joint cartilage
- Defective lubricating mechanisms
- Incompletely treated congenital dislocation of the hips
How is OA classified
- PRIMARY; unknown cause. - Common in elderly people
- due to wear and tear
- localised or generalized. - SECONDARY
due to predisposing causes e.g. injury, previous infections, RA, obesity, deformity, hyperthyroidism
Symptoms of OA
- Localized joint pain- worsens with activity and relieved by rest
- severe disease may have pain at rest
- Weight bearing joints may lock or give way – advanced disease
- Stiffness in the morning or following inactivity rarely exceeds 30 minutes
- Pain worse at the end of the day
Signs of OA
- Bony enlargement
- Crepitus= a popping, clicking or crackling sound in a joint.
- Cool effusions
- Decreased range of motion
- Tenderness on palpation at the joint line
- Pain on passive motion
- Absent in OA is the boggy synovitis in inflammatory arthritis
- Distribution- more weight bearing joints but can involve the hands
Clinical Features of OA
- Pain
- Stiffness
- Muscle weakness or wasting
- Joint enlargement and instability
- Joint effusion
- Crepitus
- Deformity
- Restricted movement
- Muscle spasm
Diagnosis of OA
- HISTORY
- EXAM
- LAB TESTS
- ESR (erythrocyte sedimentation rate)= rate at which RBC’s sediment in a period of one hour, it is a non-specific measure of inflammation.
- Rheumatiod factor titers = antibody
- Evaluation of synovial fluid
- Radiographic study of affected joints
Management of OA
-
prevention in the form;
1. education
2. relieve symptoms, control swelling and pain.
3. minimize handicap
4. limit progression, and prevent disabilities. - medical management (MEDS)
1. analgesics like paracetamol and ibuprofen
2. NSAID
3. intra-articular corticosteriods
4. tropical treatments
Surgical management
- joint replacement
- osteotomy (remove, shorten, lengthen or change alignment)
- bony decompression
- Arthroscopic washout
