Flashcards in DJD of Extra-spinal and Spinal Origin Deck (39)
T/F: Primary OA is age-related and generalized.
TRUE [some refer to hand OA only, some refer to knee, spine, and hip]
T/F: Secondary OA is post-traumatic or a result of other joint afflictions
What does EOA stand for?
What is the most common articular disorder and can be thought of as a gradual biochemical breakdown of articular (hyaline) cartilage?
OA is currently believed to involve the entire joint complex, what three things does it include?
2. Spongy bone
4. Subchondral bone
Cartilage, synovium, subchondral bone
Are these joints listed below, typical or atypical?
- Knees, hips, Cervical Lumbosacral spine, DIP, 1st CMC [thumb, and trapezium-scaphoid-trapezoid complex], 1st TMT [hallux]
Typical [can also be thought of as 'weight-bearing' bones]
Are these joints listed below, typical, atypical or 2ndary?
- Wrist, elbow, shoulder, ankle, MCP
Atypical or 2ndary
T/F: The etiology of OA is poorly understood, and daily stresses contribute to chondrocyte disruption and decreased catabolic processes. Subtle or unrecognized congenital or acquired joint alterations may accelerate breakdown of articular cartilage.
FALSE: Daily stresses contribute to chondrocyte disruption and INCREASED catabolic processes. Subtle or unrecognized congenital or acquired joint alterations may accelerate breakdown of articular cartilage.
Age, Obesity, Trauma, significant family history, muscle weakness (instability), osteochondral and meniscal injury and nutritional deficiency are all considered what?
A process known as _____ followed by subchondral cysts (microcysts) formation and abnormal proliferation of marginal bone known as osteophytes
In the pathophysiology of OA, initial damage to chondrocytes leads to reactive increase in _____ with thickening and softening of _____ cartilage followed by subsequent microscopic flaking, fibrillation (vertical clefts) and breakdown, thinning and denudation of the underlying bone.
T/F: In dealing with pathophysiology, abnormal hypovascularity of the subchondral bone leads to osseous thickening and hypodensity.
FALSE: In dealing with pathophysiology, abnormal HYPERvascularity of the subchondral bone leads to osseous thickening and HYPERdensity
What are the general radiologic features of OA, the acronym of L.O.S.S. is used, what does it stand for?
L - loss of joint space
O - osteophytes
S - subchondral sclerosis
S - subchondral cysts
What is the most common site of extra-spinal OA? And why is it common?
- Knee OA
- It is common due to its 3-compartment articulation
What are the 3-compartments of the knee?
- Medial femorotibial compartments
- lateral femorotibial compartments
- patellofemoral compartment
Which compartment of the knee is most commonly affected by OA?
- Medial femorotibial compartment
Is genu varum or genu valgum deformity more common in the knee?
[Note: knee deformities can contribute to unicompartmental OA]
Joint stiffness in the morning lasting less than 30 minutes can be confidently classified as what?
At rest, there is something called a 'gelling phenomenon'
Joint stiffness in the AM lasting longer than 30 minutes can be confidently classified as what?
Inflammatory Arthritis [ex. rheumatoid arthritis]
Crepitus and some swelling is known as...
What are the demographics of Knee OA?
- >50% of adults over 65 y/o
- Women > Men (7:1), due to sex hormone decline at 55 y/o
- Obese patients may develop OA earlier
Is there systemic involvement with knee OA?
T/F: Positive blood tests for CRP, ESR, RF, ANA, and an elevated WBC in Knee OA
FALSE: Negative blood tests for CRP, EAR, RF, ANA, and no elevation of WBC
What type of imaging is used to look at OA, and what type is used to grade the severity of OA
X-ray, and X-ray
What is the grading scale of OA?
- Minor [<3 mm]
- Severe [advanced]
In advanced cases of knee OA, intra-articular ________ may be observed as chondromatosis or broken off osteophytes.
osteocartilagenous loose bodies
Within the articular surface, central osteophytes correspond with what?
Sharpening of the tibial spines (especially anterior)
Are subchondral cysts seen in knee OA?
Not much, more in Hip OA
T/F: Patellofemoral cartilage is one of the thinnest in the body.
Where is the cartilage breakdown more noted in the patella?
What are the findings of PF OA?
L.O.S.S. of joint space
[Note: if PF OA is isolated, consider another pathology aside from knee OA]
When dealing with advanced cases of PF OA, a pressure erosion of anterior femoral cortex by disturbed quadricep muscles and patella changes can be observed...
Yes, just know this
If a patient has numerous coalesced osteocartilagenous loose bodies that lead to 2ndary osteochondromatosis
Is OA erosive?
Knee OA treatment consists of 3 types of treatment...
Conservative: PT, Chiro, ex, weight loss
Pharmacological: NSAID, corticosteroids
Surgical: Arthroscopy arthroplasty
Is OA common in the hip?
What sydrome can contribute to early OA especially in men 25-50?
On the physical exam of the hip for OA, what may be seen?
Limited ROM with frequent flexion deformity