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Session 4 CM Rheum-2

CM- Rheum -2- OA

What is the most common type of arthropathy Osteoathritis
Is OA typically inflammatory or non-inflammatory Non- Inflammatory
Does the pahtophysiology of OA vary depending on the joint type involved no it is the same regardless of joint involved
What is OA progressive deterioration and loss of articular cartilage leading to loss of normal joint strucutre and function
What is the primary etiology of OA aging or idiopathic there cand be gentic such as Nodal OA
What is secondary OA OA caused by disorders that damage joint surface
What are the pathological characterisitcs of OA Altered chondrocyte function, loss of cartilage (thinning), subchondral bone thickening (sclerosis), Remodeling of bone, marginal spurs (osteophytes), cystic changes in subchondral bone and mild reactive synovitis
What are some systemic risk factors for OA age, obesity, gentics, gender, menopause(?)
What are some local factors that can influence risk of OA Muscle strenght, joint proprioception, repetitive use, configuration of joint, trauma
What are the common locations for OA cervical spine, lumbar spine, 1st cmc (carpometacarpophalangeal), PIP, DIP, Hip, Knee, 1st MTP (metatarsophalangeal)
What are some uncommon locations for OA SHoulder, Thoracic Spine, Elbow, Wrist, MCP (metacarpophalangeal), Ankle, Subtalar
What are the 7 subsets of OA Generalized OA, Nodal OA, Spondylosis, Erosive OA, Inflammatory OA, Diffuse idiopathic skeletal hyperostosis (DISH), Chondromalacia patellae
Where are heberden's nodes found DIP
Where are bouchards nodes found PIP
Where is the most common location to find nodes in OA Knees 3 compartments med/lat/pat-fem
What are the common symptoms of OA insidious onset of joint pain w/ movement, limitation of motion, referred pain, minimal stiffness after rest, (systemic symptoms are rare)- acute flares of these symptoms suggest another dx
Why do you get pain in OA if the cartilage is avascualr and aneuritic could cause synovitis, joint capsule/ligament stretchin, periosteal irritation from osteophytes, travecular microfractures, muscle spasm, intraosseous hypertension
What physical exam findings would you expect to find in an OA patient Bondy changes in joint shape, crepitus, malalignement/instability, limited ROM, join line tenderness, cool effusions, spasm or atrophy of adjacent muscle
What lab tests are indicative of OA non really but ESR and RF appropriate for age and synovial fluid shiould be class 1 (non-inflammatory)
What x-ray findings are indicative of OA cartilage loss/joint space narrowing, subchondral sclerosis, osteophytes at joint margins, subchondral cysts
What is Genu Varus bowleg
This type of OA is marked by exuberant osteophytosis of the spine spanning 3-4 vertebral segments with preservation of disc spaces. Ligament calcification is noted. Diffuse Idiopathic Skeletal Hyperostosis (DISH)
Who is more affected with DISH diffuse idiopathic skeletal hyperostosis M>F
What other pathology is diffuse idiopathic skeletal hyperostosis (DISH) associated with Diabetes Mellitus
A person with dish may develop anterior cervical osteophytes what may that cause them to have dysphagia
What are some of the ways to manage a pt with OA education, weight reduction, nutriceuticals, topical agents, analgesics, NSAIDs, phyical therpay, occupational therapy, surgery, conditioning, Intra-articular steroids, Viscosupplementation, SMOADS (systemic modulating osteoarthritic drugs)
What are SMOADS (systemic modulating osteoarthritic drugs) in management of OA MMPI, Residronate, Doxycycline, Glucosamine, Chondroitin
How is capsaicin work in tx of OA it is a topical agent that can be rubbed on the joint it causes a rxn that with time will cause a person to exhaust their supply of substance P which without they don't have pain.
What is the primary analgesic in management of OA acetaminophen (3g maximum per day) easily overdosed on
What is the definitive tx for OA Surgery
What are the tx goals for OA pain control, improve function, enhance health related quality of life, avoid Rx related side effects. Sadly there is not cure
What are the essential to dx of OA degenerative disorder w/o systemic manifestations, pain relived by rest, morning stiffness, articular inflammation is minimal, x-ray finding of joint space narrowing, osteophytes, increased subchondral bone, bone cysts
Created by: smaxsmith