Flashcards in Osteoarthritis Deck (14)
What is the commonest form of joint problem?
How is osteoarthritis defined?
-Tear, flare and repair
What are the key processes of osteoarthritis?
-Trauma and mechanical imbalance
-Inflammation and pain
-Repair processes around the joint
What biochemical factors are there?
-Abnormal anatomy (DDH)
-Occupation – farmers, football players
-Persistent heavy physical activity
What contributes to inflammation?
What biochemical mediators are elevated in OA?
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
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
What symptoms suggest it isn't OA and another cause should be looked for?
-Prolonged morning stiffness
-Rapid deterioration of symptoms
-Hot, swollen joint
What is the differential diagnosis for OA?
-Other inflammatory arthritides
What non-pharmacological treatments are there for OA?
-Aids and devices
-NICE do not recommend: acupuncture, nutraceuticals (glucosamine, chondroitin)
What pharmacological treatments are there for OA?
-Oral analgesia: paracetamol, NSAIDs
-Topical treatments: NSAIDs, capsaicin (knee, hand)
When should OA be referred to surgery?
-Substantial impact on quality of life
-Refractory to non-surgical treatment