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32 Cards in this Set
- Front
- Back
What does Osteoarthritis mean? What are the effects on people/country?
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- Degenerative joint disease
- Frequent part of aging and important cause of physical disability in persons >65 - Costs >$33 billion / year |
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What is the most common joint disorder?
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Osteoarthritis
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Is Osteoarthritis an inflammatory process?
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No - it implies an inflammatory process; however it is primarily a degenerative disorder of articular cartilage
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What happens to chondrocytes in osteoarthritis?
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Respond to biomechanical / biologic stresses in a way that results in breakdown of matrix
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What are the primary changes in Osteoarthritis? Secondary changes?
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- Primary = degeneration of articular cartilage
- Secondary = structural changes in underlying bone |
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What is the normal function of Chondrocytes?
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- 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 |
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What are the necessary characteristics of Cartilage to be effective in joints? What makes these characteristics?
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- Needs to be elastic (to regain normal architecture after compression) --> Proteoglycans
- Needs to have high tensile strength --> Type II collagen |
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What is the function of Proteoglycans in Cartilage?
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Makes cartilage elastic so it can regain normal architecture after compression
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What is the function of Type II Collagen in Cartilage?
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Makes cartilage have high tensile strength
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Is articular cartilage a dynamic substance?
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Yes - it is constantly undergoing matrix degradation and replacement
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What can affect the susceptibility to Osteoarthritis?
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- 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 |
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What are some predisposing factors to Osteoarthritis?
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- 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 * |
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What is Ochronosis? Significance to Osteoarthritis?
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- Bluish-black discoloration of certain tissues, seen with alkaptonuria, or from exposure to certain substances
- Predisposing factor to Osteoarthritis |
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What is Hemochromatosis? Significance to Osteoarthritis?
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- Iron overload
- Predisposing factor to Osteoarthritis |
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Why does obesity predispose for Osteoarthritis?
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Excessive weight on joints
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At what age does Primary Osteoarthritis usually begin? Cause?
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- Insidiously w/ age (50-60s)
- No apparent initiating cause |
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How many joints does Osteoarthritis affect usually? Which joints?
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- Oligoarticular w/ joints of hands, knees, hips, and spine most commonly affected
- Women: knees and hands - Men: hips |
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What are the signs and symptoms of Osteoarthritis?
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- 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 |
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What are Heberden nodes? Who is most likely to have them?
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- Prominent osteophytes at DIPs
- Characteristic of Osteoarthritis in women |
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What does the articular cartilage look like in Osteoarthritis?
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- Initially, granular-appearing (chondromalacia)
- Eventually, full-thickness portions of cartilage are lost, and subchondral bone plate is exposed |
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What is Eburnation?
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Ivory-like bone reaction of bone occurring at site of cartilage erosion d/t repetitive friction and polishing of exposed bone
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What is the process of polishing (e.g. repetitive friction) exposed bone to make it look ivory at sites of cartilage erosion?
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Eburnation (in Osteoarthritis)
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What are "Rice bodies" / "Joint mice" / loose bodies?
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- Small fractures can dislodge pieces of cartilage and subchondral bone into the joint in Osteoarthritis
- When removed they are shiny (characteristic of cartilage) |
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What causes Fibrous Walled (Subchondral) Cysts?
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Fracture gaps in bone allow synovial fluid to be force into the subchondral regions
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What is a subchondral cyst filled with?
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Synovial fluid
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What can develop at the margins of the articular surface in Osteoarthritis?
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Mushroom-shaped osteophytes (bony outgrowths)
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What can cover the peripheral portions of the articular surface in Osteoarthritis?
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Fibrous synovial pannus
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What happens to the joint in Osteoarthritis?
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- Irregular joint space
- Fragmented cartilage - Loss of cartilage - Sclerotic bone - Cystic change (subchondral cysts) |
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What happens to the joint in advanced Osteoarthritis?
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- Osteophyte formation
- Periarticular fibrosis - Calcified cartilage |
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Can you predict Osteoarthritis or halt the progression?
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- No prediction or ability to stop progression
- May stabilize for years, but generally is slowly progressive |
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What is the long-term difference between Rheumatoid Arthritis and Osteoarthritis?
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In RA, fusion can occur; in Osteoarthritis, fusion does NOT occur
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What is the treatment for Osteoarthritis?
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- Based on symptom relief
- Joint replacement in severe cases |