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23 Cards in this Set

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