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Flashcards in Osteoarthritis Deck (16)
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1
Q

What is osteoarthritis (OA)?

A

Articular cartilage thinning or loss
=> bones rub together
=> pain in joints

2
Q

Why is ageing a risk factor for OA?

A

more “wear and tear” over your lifetime

3
Q

What are the risk factors for developing OA?

A
Age
Female
Obesity
Previous injury
Muscle weakness
Proprioceptive deficits
Genetics
Acromegaly (excess growth hormone)
Joint inflammation
Crystal deposition
4
Q

What types of OA exist?

A

IDIOPATHIC
-no known cause

SECONDARY

  • Previous injury
  • Calcium crystal deposition
  • Rheumatoid arthritis `
5
Q

Describe the anatomical distribution of joints affected in OA

A
Hand
Cervical spine
Lumbar spine
Hip
Knee
Foot (MTP joints)
6
Q

What are the typical symptoms of OA?

A

Pain – worse on activity and relieved by rest.
May progress to be present with less activity and at rest or at night

Stiffness – usually morning stiffness lasts less than 30 mins

7
Q

What can be seen or palpated on examination of osteoarthritic joints?

A

Crepitus
Joint swelling -Bony enlargements due to osteophytes
Joint tenderness
Joint effusion

8
Q

What clinical features of OA are specific to the hands?

A

Bony enlargements at:

  • DIPs (Heberdens nodes)
  • PIPs (Bouchards nodes)

Squaring of the hand

9
Q

What clinical features of OA can be present in the knee?

A

Osteophytes
effusions
crepitus
restriction of movement

Genu varus or valgus deformities
Bakers cyst

10
Q

Where would OA pain in the hip potentially radiate to?

A

Pain may be felt in groin or radiating to knee

Pain felt in hip may be radiating from the lower back

11
Q

What clinical features can be present in the spine?

A

Cervical – pain and restriction of neck movement

Lumbar – Pain on standing or walking for some time.

osteophytes can cause spinal stenosis if encroach on spinal canal or pinch the nerve root

12
Q

What acronym is used to analyse an X-Ray in suspected OA

A

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

(LOSS)

13
Q

Describe the different Kellgren-Lawrence grading levels of OA

A

Grade 0 - No radiographic findings of osteoarthritis

Grade 1 - Minute osteophytes of doubtful clinical significance

Grade 2 - Definite osteophytes with unimpaired joint space

Grade 3 - Definite osteophytes with moderate joint space narrowing

Grade 4 - Definite osteophytes with severe joint space narrowing and subchondral sclerosis

14
Q

What non-pharmacological management is often used in OA

A

Physiotherapy- muscle strengthening, proprioceptive

‘Common sense measures’ - weight loss exercise, trainers, walking stick, insoles

15
Q

What pharmacological management is often used in OA

A

Analgesia – paracetamol, compound analgesics, topicals

NSAIDs - topical/systemic

Pain modulators

  • tricyclics eg. amitriptyline
  • anti-convulsants eg. Gabapentin

Intra-articular – Steroids, Hyaluronic acid

16
Q

What surgical management can be used in OA?

A

Arthroscopic washout
Loose body/soft tissue trimming.

Joint replacement