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32 Cards in this Set

  • Front
  • Back
What does Osteoarthritis mean? What are the effects on people/country?
- Degenerative joint disease
- Frequent part of aging and important cause of physical disability in persons >65
- Costs >$33 billion / year
What is the most common joint disorder?
Osteoarthritis
Is Osteoarthritis an inflammatory process?
No - it implies an inflammatory process; however it is primarily a degenerative disorder of articular cartilage
What happens to chondrocytes in osteoarthritis?
Respond to biomechanical / biologic stresses in a way that results in breakdown of matrix
What are the primary changes in Osteoarthritis? Secondary changes?
- Primary = degeneration of articular cartilage
- Secondary = structural changes in underlying bone
What is the normal function of Chondrocytes?
- Provide friction-free movement w/in joint (lubricated by synovial fluid)
- Acts as a cushion in weight-bearing joints by spreading the load across the joint surface and allowing underlying bones to absorb shock and weight
What are the necessary characteristics of Cartilage to be effective in joints? What makes these characteristics?
- Needs to be elastic (to regain normal architecture after compression) --> Proteoglycans
- Needs to have high tensile strength --> Type II collagen
What is the function of Proteoglycans in Cartilage?
Makes cartilage elastic so it can regain normal architecture after compression
What is the function of Type II Collagen in Cartilage?
Makes cartilage have high tensile strength
Is articular cartilage a dynamic substance?
Yes - it is constantly undergoing matrix degradation and replacement
What can affect the susceptibility to Osteoarthritis?
- Normal chondrocyte function to maintain cartilage synthesis and degradation balance
- Genetic factors, including polymorphisms and mutations in genes encoding components of matrix and signaling molecules
What are some predisposing factors to Osteoarthritis?
- Previous trauma (including fractures that prevent joints from returning to normal shape)
- Developmental deformity (e.g., congenital scoliosis, hip dysplasia, etc.)
- Underlying systemic disease (ochronosis, hemochromatosis, marked obesity)
* This makes Osteoarthritis called Secondary Osteoarthritis *
What is Ochronosis? Significance to Osteoarthritis?
- Bluish-black discoloration of certain tissues, seen with alkaptonuria, or from exposure to certain substances
- Predisposing factor to Osteoarthritis
What is Hemochromatosis? Significance to Osteoarthritis?
- Iron overload
- Predisposing factor to Osteoarthritis
Why does obesity predispose for Osteoarthritis?
Excessive weight on joints
At what age does Primary Osteoarthritis usually begin? Cause?
- Insidiously w/ age (50-60s)
- No apparent initiating cause
How many joints does Osteoarthritis affect usually? Which joints?
- Oligoarticular w/ joints of hands, knees, hips, and spine most commonly affected
- Women: knees and hands
- Men: hips
- Oligoarticular w/ joints of hands, knees, hips, and spine most commonly affected
- Women: knees and hands
- Men: hips
What are the signs and symptoms of Osteoarthritis?
- Deep, aching pain exacerbated by use
- Morning stiffness
- Crepitus (grating/popping sensation in joint)
- Limitation in ROM
- Heberden nodes (prominent osteophytes at DIPs) - women
- Osteophyte impingement on spinal foramina --> nerve root...
- Deep, aching pain exacerbated by use
- Morning stiffness
- Crepitus (grating/popping sensation in joint)
- Limitation in ROM
- Heberden nodes (prominent osteophytes at DIPs) - women
- Osteophyte impingement on spinal foramina --> nerve root compression w/ radicular pain, muscle spasms, muscle atrophy, and neuro defects
What are Heberden nodes? Who is most likely to have them?
- Prominent osteophytes at DIPs 
- Characteristic of Osteoarthritis in women
- Prominent osteophytes at DIPs
- Characteristic of Osteoarthritis in women
What does the articular cartilage look like in Osteoarthritis?
- Initially, granular-appearing (chondromalacia)
- Eventually, full-thickness portions of cartilage are lost, and subchondral bone plate is exposed
What is Eburnation?
Ivory-like bone reaction of bone occurring at site of cartilage erosion d/t repetitive friction and polishing of exposed bone
Ivory-like bone reaction of bone occurring at site of cartilage erosion d/t repetitive friction and polishing of exposed bone
What is the process of polishing (e.g. repetitive friction) exposed bone to make it look ivory at sites of cartilage erosion?
Eburnation (in Osteoarthritis)
What are "Rice bodies" / "Joint mice" / loose bodies?
- Small fractures can dislodge pieces of cartilage and subchondral bone into the joint in Osteoarthritis
- When removed they are shiny (characteristic of cartilage)
- Small fractures can dislodge pieces of cartilage and subchondral bone into the joint in Osteoarthritis
- When removed they are shiny (characteristic of cartilage)
What causes Fibrous Walled (Subchondral) Cysts?
Fracture gaps in bone allow synovial fluid to be force into the subchondral regions
Fracture gaps in bone allow synovial fluid to be force into the subchondral regions
What is a subchondral cyst filled with?
What is a subchondral cyst filled with?
Synovial fluid
Synovial fluid
What can develop at the margins of the articular surface in Osteoarthritis?
Mushroom-shaped osteophytes (bony outgrowths)
Mushroom-shaped osteophytes (bony outgrowths)
What can cover the peripheral portions of the articular surface in Osteoarthritis?
Fibrous synovial pannus
Fibrous synovial pannus
What happens to the joint in Osteoarthritis?
- Irregular joint space
- Fragmented cartilage
- Loss of cartilage
- Sclerotic bone
- Cystic change (subchondral cysts)
- Irregular joint space
- Fragmented cartilage
- Loss of cartilage
- Sclerotic bone
- Cystic change (subchondral cysts)
What happens to the joint in advanced Osteoarthritis?
- Osteophyte formation
- Periarticular fibrosis
- Calcified cartilage
- Osteophyte formation
- Periarticular fibrosis
- Calcified cartilage
Can you predict Osteoarthritis or halt the progression?
- No prediction or ability to stop progression
- May stabilize for years, but generally is slowly progressive
What is the long-term difference between Rheumatoid Arthritis and Osteoarthritis?
In RA, fusion can occur; in Osteoarthritis, fusion does NOT occur
What is the treatment for Osteoarthritis?
- Based on symptom relief
- Joint replacement in severe cases