Flashcards in Osteoarthritis Deck (29):
What is Osteoarthritis ?
Articular cartilage failure
loss of joint space
Subchondral cyst formation
What happens in OA?
Loss of matrix
release of cytokines including IL-1 and TNF
Release of metalloproteinases and prostaglandins by chondrocytes
What accompanies fibrillation of the cartilage surface?
Attempts of repair and osteophyte formation
What is a clinical presentation of OA?
Pain, typically on activity and relieved by rest.
stiffness usually in the morning (lasts less than 30 mins)
What is found on examination with OA?
Bony enlargements due to osteophytes
What joints are involved with OA?
Dip, PIP, and 1st CMC joints
What kind of deformities are found in the knee?
Genu varus (away from midline)
Valgus (to the midline)
What else can occur in the knee with OA?
Where is pain felt in OA of the hip?
In the groin and radiating to the knee.
May be radiating from the lower back
What can occur at the lumbar spine?
Spinal stenosis caused by osteophytes when encroached on spinal canal
What radiological signs can show OA?
Loss of joint space
In OA, what grading scale is uses?
The Kellgren-Lawrence Radiographic scale of OA
How is OA managed?
Common sense e.g. weight loss
What drugs can be used to treat OA?
What can be done in surgery to help with OA?
Arthroscopic washout, loose body, soft tissue trimming
What is Gout?
Inflammation in the joint triggered by uric acid crystals
What is chronic tophaceous gout?
Chronic joint pain, often associated with diuretics.
High serum uric acid
Tophi, may get acute attacks
What investigations may you do for suspected gout?
Serum uric acid levels
polarised microscopy of synovial fluid
What are treatments for Gout?
What prophylaxis treatment can you give?
What does chondrocalcinosis affect?
Fibrocartilage in the knees, wrists and ankles
What is chondrocalcinosis, aka CPPD?
Calcium Pyrophosphate Deposition Disease
What causes CPPD?
Pseudogout, calcium pyrophosphate crystals
What are treatments for CPPD?
Hydroxyapatite is also known as what?
What is Hydroxyapatite?
Hydroxyapatite crystals in or around the joint
What is released in Hydroxyapatite?
Collagenases, serine proteinases and IL-1
What is the treatment for Hydroxyapatite?
Intra-articular steroid injection
Partial or total arthroplasty.