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9 Cards in this Set
- Front
- Back
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What is the pathogenesis of osteoarthritis?
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Stress of collagen causes inflammation
Disrupted balance between wear and production of collagen via chondrocytes Oedematous cartilage Erosion of bone Chondrocytes die and bone exposed Osteophytes grow leaving bone over growth |
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What causes osteoarthritis?
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Primary - no known cause
Secondary - previous joint damage, Metabolic diseases, systemic disease (haemophilia, neuropathy) |
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What are risk factors for OA?
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Genetics
Obesity Female Hypermobility Osteoporosis Trauma Congenital deformity Occupation Sport |
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What are the symptoms of OA?
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Polyarthritis
Joint pain - weight bearing and nocturnal worse Joint gelling Joint instability Loss of function Joint tenderness Crepitus Limited movement Joint effusion Bony swellings - DIP = Heberdens, PIP= Bouchardsm, 1st CMC squaring Muscle wastage Altered gait - antalgic or trendelenberg |
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What are the characteristics of OA of the hand?
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DIP > PIP
Painful onset Tenderness and swelling Impaired function Late middle age Good long term outcomes OA of hip, knee and spine associated |
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What are the characteristics of hip OA?
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Joint space narrowing, sclerosis
Male more common Unilateral/bilateral presentation Acetabular dysplasia Osteophytes |
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What are the characteristics of knee OA?
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Elderly and females
Bilateral Related to obesity Polyarticular hand OA associated Varus deformity Retropatellar OA RF = trauma, meniscal and cruciate ligament tears |
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What are the investigations for OA?
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Bloods - normal ESR and CRP, No Rheumatoid factor or antinuclear antibodies
X ray - abnormal if advanced, severity MRI - meniscal tears, cartilage injury, subchondral bone changes Arthroscopy - Early fissuring and surface erosion of cartilage Aspiration of synovial fluid - few leukocytes |
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How is OA managed?
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Symptomatic treatment
Weight loss NSAIDS Heat/ice Analgesia Coxibs Corticosteroid injections Surgery |
