Rheumatology: Osteoarthritis, Crystal Arthropathies, Soft tissue Rheumatism Flashcards
(63 cards)
What is Osteoarthritis typically described as?
“wear and tear” of the joints
What are the risk factors for developing osteoarthritis?
Age, muscle weakness, occupation, genetic elements, sports, previous injuries
What is the link between osteoarthritis and osteoporosis?
Can’t have both, osteoporosis protects against osteoarthritis
What can be seen on an osteoarthritis X-ray?
LOSS Loss of joint space Oesteophytes Sclerosis Subchondral cysts
What are osteophytes?
Bone spurs with jagged edges
What happens in subchondral cysts?
Synovial fluid flows into breaks in the cartilage
What are factors which contribute to development of osteoarthritis?
Complex interplay of many factors: genetic, joint integrity, mechanical force and cellular and biochemical forces
Who is commonly affected by osteoarthritis?
1/3rd of population over age of 45, 1/2 population over 70
What are the different types of osteoarthritis?
Idiopathic or Secondary
What can Idiopathic osteoarthritis be further divided into?
Localised (1 site) or generalised (3 or more sites)
What can cause secondary osteoarthritis?
Previous injury, genetic elements, rheumatoid arthritis, agromegally, calcium crystal deposition
What is the typical clinical presentation of osteoarthritis?
Pain, worse of activity and relieved by rest
Stiffness in morning lasting
What can be seen on examination is osteoarthritis?
Crepitus, swelling (bony enlargements due to osteophytes), Heberden’s nodes and Bouchard’s nodes
Later stages: joint tenderness and effusion
What joints can be affected by osteoarthritis?
All weight baring joints of lower limb: hip, knee, ankle, tarsal, metatarsals
Hands, arms and spine
What clinical features can be seen on the knee in osteoarthritis?
Baker’s cyst, gene varus, gene valgus
What is gene varus and what is it seen as clinically?
Knee moving towards the midline, seen as bow legged clinically
What is gene valgus and what is it seen as clinically?
Knee moving away from the midline, seen as knock-kneed clinically
What can be seen on the hands on examination in osteoarthritis?
Bouchard’s nodes and Heberden’s nodes and squaring of the thumbs
How is the spine affected in osteoarthritis?
- Mainly facet joints affected
- Osteophytes may compress the nerve roots
- Cervical area affected causes restriction of movement and pain
- Osteophytes at lumbar region can cause spinal stenosis, and if encroaches on spinal canal can cause problems with walking, spinal claudication
How can hip pain be felt in osteoarthritis?
As pain radiating to the knee or groin
What is the natural history of progression of osteoarthritis in the hands?
Over a 2 year period, pain often improves although swelling becomes more marked
What is the natural history of progression of osteoarthritis in the knee?
1/3 of patients’ symptoms improve, 1/3 are stable and 1/3 deteriorate
What is the natural history of progression of osteoarthritis in the hip?
10% come off the surgical waiting list as symptoms improve
What are the non pharmacological interventions in osteoarthritis?
Explanation, physiotherapy and “common sense measures” such as weight loss, walking stick and exercise
