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Yr3 MSK > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (16)
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1
Q

How common is it?

A

Osteoarthritis affects >50% of the >60 population in the UK

2
Q

What are the types of osteoarthritis?

A

Primary - Microtrauma over a long period

Secondary - A single acute trauma

3
Q

What factors presdispose to osteoarthritis?

A
  • Abnormal anatomy e.g. DDH
  • Intra-articular fracture
  • Ligament rupture
  • Meniscal injuries
  • Occupation e.g .farmers and footballers
  • Persistent heavy activity e.g. running
  • Obesity
4
Q

Describe the pathogenesis of Osteoarthritis?

A

Trauma & mechanial imbalance
-> Damaged joint
-> Inflammation & pain
-> Synovial hypertrophy -> Joiny effusion
+ Subchondral changes -> Uneven articular surface

Along with the repair processes around the joint you end up with a persistently inflamed and imbalanced joint

5
Q

Describe the presentation of Osteoarthritis?

A

45yrs plus with activity related joint pain (most often in hip or knee) + Restriction of function

Important: None or >30mins of early morning stiffness (otherwise points to other arthritidis)

6
Q

Where does the pain of OA appear?

A

Hip OA - Groin pain +/-radiation down thigh to knee

Knee OA - Pain in ant knee

7
Q

Some presentations that are unlikely to be OA:

A

LArge trauma
Prolonged early morning stiffness
Rapidly deteriorating symptoms
Hot and/or swollen joint

8
Q

DDX for OA?

A

Gout
Inflammatory Arthritidis e.g. RA
Septic ARthritis
Malignancy

9
Q

How do diagnose OA?

A

Clinically, but if unusual do:

  • X-ray
  • CRP/ESR
10
Q

How do we manage OA (in short)?

A
In this order:
Self management and holistic care
Exercise and weight loss
Non-pharmacological therapies
Analgesia & Topical treatments
Surgery
11
Q

Describe the parts of OA self-management?

A

Thermotherapy i.e. heat/ice
Rest or changed activity
OTC painkillers

12
Q

Describe the importance of OA holistic care?

A
Most cases are dealt without meds/surgery.
Need to address the patient's:
- Depression
- Ability to work
- Family roles
- Social isolation
- Daily living/hobbies
13
Q

What non-pharmacological therapies can we offer for OA?

A

Thermotherapy
Electrotherapy (TENS)
Aids/devices e.g. walking stick
MAnual Therapy e.g. Physio

14
Q

What pharmacological therapies can we offer for OA?

A

ORal Analgesia e.g. paracetamol or NSAIDs

Topical e.g. NSAIDS or Capsaicin cream

15
Q

When would we refer OA for surgery?

A
  • Substantial impact on QOL

- Or Refractory to other treatments

16
Q

What surgery can we do for OA?

A

Joint Replacement