Flashcards in Osteoarthritis Deck (14)
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1
What is the commonest form of joint problem?
Osteoarthritis
2
How is osteoarthritis defined?
-Tear, flare and repair
3
What are the key processes of osteoarthritis?
-Trauma and mechanical imbalance
-Inflammation and pain
-Repair processes around the joint
4
What biochemical factors are there?
-Abnormal anatomy (DDH)
-Intra-articular fracture
-Ligament rupture
-Meniscal injury
-Occupation – farmers, football players
-Persistent heavy physical activity
-Elite running
-Obesity
5
What contributes to inflammation?
-Synovial hypertrophy
-Subchondral changes
-Joint effusion
6
What biochemical mediators are elevated in OA?
-IL-1B
-TNFa
-MMPs
7
What is the pathogenesis of OA?
-Muscle weakness, ligament injury or abnormal anatomy on lead to instability and ,misalignment
-Instability and obesity increase the load and lead to joint microtrauma
-Formation of OA joint and synovitis
8
What is the criteria for an OA diagnosis?
-45 years +
-Activity-related joint pain plus
-Has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes
9
What symptoms suggest it isn't OA and another cause should be looked for?
-Trauma
-Prolonged morning stiffness
-Rapid deterioration of symptoms
-Hot, swollen joint
10
What is the differential diagnosis for OA?
-Gout
-Other inflammatory arthritides
-Septic arthritis
-Malignancy
11
What non-pharmacological treatments are there for OA?
-Thermotherapy
-Electrotherapy
-Aids and devices
-Manual therapy
-NICE do not recommend: acupuncture, nutraceuticals (glucosamine, chondroitin)
12
What pharmacological treatments are there for OA?
-Oral analgesia: paracetamol, NSAIDs
-Topical treatments: NSAIDs, capsaicin (knee, hand)
13
When should OA be referred to surgery?
-Substantial impact on quality of life
-Refractory to non-surgical treatment
-Referral letter
14
