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Systems: MSK AB > Osteoarthritis > Flashcards

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

What radiological findings are there in OA?

-Joint space narrowing
-Subchrondral sclerosis
-Cysts
-Osteophyte formation