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23 Cards in this Set
- Front
- Back
OA risk factors
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1. age (all sites)
2. female (knee and hand) 3. genetic predisposition (all sites) 4. obesity (hip, knee) 5. Malalignment 6. Congenital or acquired in childhood |
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OA common locations
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-cervical spine (spondylosis)
-lumbar spine -hands -hips -knees |
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functions of cartilage
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1. protection
2. shock absorption 3. ROM |
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cartilage pathophys
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-water (65-80%)
-collagen (fibrous protein) -proteoglycans |
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as the cartilage degrades...
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-new bone formation occurs
-osteophytes |
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OA the process
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-Bone suffers microfractures and proliferates in an attempt to heal
-The proliferative new bone interferes with function and causes PAIN |
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chondrocytes
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-maintain the health and function of the cartilage
-migrate as the process progresses |
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OA ssx
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1. PAIN with inc use
2. stiffness <15-30 min 3. limited ROM 4. Crepitus 5. Antalgic gait 6. boney hypertrophy and JOINT LINE TENDERNESS on palpation |
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sources of pain
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Synovial membrane
Joint capsule Ligaments Muscle spasm Periosteum Subchondral bone- cyst formation |
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Dx OA knee clinical and labs
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-knee pain +5 out of 9
1. age >50 2. stiffness <30 min 3. crepitus 4. bony tenderness 5. bony enlargement 6. no palpable warmth 7. ESR <40 8. RF <1:40 |
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Dx OA knee clinical and radiographic
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-knee pain and 1 of 3
1. age >50 2. stiffness <30 min 3. Crepitus + osteophytes on xray |
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xrays
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-joint space narrowing, bony sclerosis, osteophytes, subchondral cyst formation
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heritable causes secondary OA
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1. hemochromatosis
2. sickle cell anemia 3. hemophulia 4. Gauchers disease |
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synovial fluid analysis
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-slide 33
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OA hands
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1. no heat or redness
2. No MCPj or wrist involvement 3. Squaring of thumb or loss of thenar muscle |
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methods of reading xrays
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ABCS
Alignment Bony mineralization Cartilage space Soft tissue |
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Popliteal cyst
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-fluid builds up in knee and goes posteriolorly
-finding in OA |
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OA physical measures
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1. PT
2. muscle toning, strenghtening 3. quad muscle strengthening 4. exercise bik 5. elipitical 6. walking fitness program |
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supportive devices
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- Canes, walkers, shoes, grab bars, toilet extenders, seat lift chairs,
-Parking permits, etc. |
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topical agents
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1. capsaicin
2. methylsalicylate and menthol (Ben Gay) 3. Bio-freeze 4. diclofenac topical-Voltaren gell |
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NSAIDs
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-reduce pain, reduce stiffness, improve mobility
-Cox 1 and 2 |
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analgesics
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acetaminophen
propoxyphene codeine hydrocodone oxycodone morphine and derivatives |
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procedures
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-joint aspiration: diagnostic or therapeutic
-joint injections: steroids, anesthetics, hyaluronic acid |