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Flashcards in Arthritides Deck (94)
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1

Define Arthritides

Types of arthritis

2

Key Manifestations of Arthritis

Pain
Swelling
Limited motion

3

Types of Joints

Fibrous/Bony
Cartilaginous
Synovial

4

Fibrous/Bony Joint Motion

Minimal to no motion

5

Cartilaginous Joint Motion

Limited motion

6

Synovial Joint Motion

Freely mobile
Comprised of 2+ bones
May have meniscus

7

Define Osteoarthritis

Degenerative arthritis or joint disease

8

Pathophysiology of Osteoarthritis

Damage to normal articular cartilage
Chondrocytes react by releasing degradative enzymes
Bone reacts with subchondral sclerosis & osteophytes
Degredation of cartilage & bony reaction
Complete loss of cartilage
Joint space narrowing & possible deformity
Hypertrophy/hyperplasia of osteocytes -> subchondral sclerosis -> osteophyte formation

9

Predisposing Factors of Osteoarthritis

Age
Female sex
Previous injury
Obesity
Heavy physical labor
Positive family history
Sports activities

10

Features of Osteoarthritis

Joint pain
Swelling
Crepitation
Tenderness
Effusions
Hands, hips, knees, spine
Tenderness on palpation & on passive motion (late signs)

11

Osteoarthritis in the Hands

Middle-aged & elderly women
Strong family history
DIP & PIP joints

12

Location of Heberden's Nodes

DIP

13

Location of Bouchard's Nodes

PIP

14

Osteoarthritis in the Shoulder

Progressive anterior shoulder pain, worse with motion
Difficulty with overhead activities, sleeping, axillary hygiene
Seen frequently with rotator cuff disease/tears, AC joint arthritis

15

Osteoarthritis of the Hip

Pain deep in the groin- can radiate to anterior thigh, knee, & buttock
Starts with prolonged standing/walking becoming intolerable
Then difficulty putting on socks/shoes
Pain with abduction

16

Osteoarthritis of the Knee

Difficulty doing stairs, getting out of low chairs, off of toilets
Pain with kneeling/squatting

17

Osteoarthritis of the Cervical Spine

Pain & stiffness
Aching pain down the arm

18

Osteoarthritis of the Lumbar Spine

Pain across low back/buttocks with LOM flex/ext
Can develop spinal stenosis

19

Diagnosis of Osteoarthritis

Clinical supported by H&P, labs, & imaging
No specific labs
X-ray sufficient

20

Findings on Osteoarthritis Imaging

Joint space narrowing
Surface irregularity
Osteophytes
Subchondral sclerosis
Subchondral cysts

21

Non-pharmacological Treatment of Osteoarthritis

Moderate weight loss
Exercises
PT/OT
Braces
Heat/cold
Rest

22

Pharmacologic Treatment of Osteoarthritis

Acetaminophen
NSAIDs
Tramadol
Opioids
Intra-articular Injections

23

Benefits of Glucocorticoid Intra-Articular Injection for Osteoarthritis

Slow cartilage degradation
Provide pain relief

24

Benefits of Hyaluronans Intra-Articular Injection for Osteoarthritis

Macromolecules absorb water & may protect cartilage

25

How to Perform a Knee Injection/Aspiration

Thorough skin prep
Supero-lateral portal
Patient supine
Sit with knee at eye level
Little pain when slow
Aspiration/injection

26

Surgical Treatment for Osteoarthritis

Arthroscopic procedures
Total joint replacement
Chondrocyte grafting

27

Arthroscopic Procedures

May aggravate underlying arthritis

28

Total Join Replacement

Gold standard for severe knee, hip, or shoulder joint arthritis

29

Chondrocyte Grafting

Perhaps for small, isolated defects

30

Benefits of Total Joint Replacement

Relieves pain
Corrects deformity
Improves function