Osteoarthritis

What are some risk factors for developing osteoarthritis?

- Age - Sex (more common in females) - Ethnicity (more common in caucasians!) - Obesity - Conditions resulting in abnormal loading of a joint (uneven distribution) - Your profession (knee - affected in athletes, Hip - affected in farmers)

What functional impairments might a person with OA have?

- Difficulty climbing stairs. - Difficult to tie shoelaces. - Difficulty opening jars.

How does the pain in osteoarthritis present?

- Gradual onset - Worse on movement and better on rest - Pain is localised to a joint, but can be referred - Brief morning stiffness.

What would an X ray of osteoarthritis look like?

- Joint space narrowing due to cartilage loss - Osteophytes at the joint margin - Subchondral sclerosis - Bone cysts - Bone loss

Which joints are commonly affected in OA?

Hips Knees DIPS (distal interphalangeal joints) Proximal interphalangeal joints (PIPS) Base of the thumb.

What is the classification for OA?

Primary - no known cause found. Secondary - Caused by trauma, infection, RA, Perthes, SUFE etc.

What is the treatment for osteoarthritis?

There is no cure. - Patient education - Obesity management. - Analgesics - NSAIDs, paracetamol, opiods, local steroid injection (You should give paracetamol first.) - Joint replacements.

Why is age a risk factor for osteoarthritis?

Your cartilage contains cell matrix and water. It consists of proteoglycans, which are spongy lumps that absorb the water under stress, therefore reducing load etc. As you get older, you have fewer and fewer proteoglycans. Therefore less water is absorbed as a shock absorber. This causes more wear and tear.

What might you notice on examination in someone with OA?

Crepitus Bony enlargement Deformity Tenderness along the joint line Restricted movement No warmness You may notice muscle wasting, weakness and swelling.

What is osteoarthritis also known as?

Degenerative joint disease.