CM- Rheum -2- OA
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| What is the most common type of arthropathy | Osteoathritis
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| Is OA typically inflammatory or non-inflammatory | Non- Inflammatory
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| Does the pahtophysiology of OA vary depending on the joint type involved | no it is the same regardless of joint involved
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| What is OA | progressive deterioration and loss of articular cartilage leading to loss of normal joint strucutre and function
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| What is the primary etiology of OA | aging or idiopathic there cand be gentic such as Nodal OA
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| What is secondary OA | OA caused by disorders that damage joint surface
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| 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
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| What are some systemic risk factors for OA | age, obesity, gentics, gender, menopause(?)
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| What are some local factors that can influence risk of OA | Muscle strenght, joint proprioception, repetitive use, configuration of joint, trauma
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| What are the common locations for OA | cervical spine, lumbar spine, 1st cmc (carpometacarpophalangeal), PIP, DIP, Hip, Knee, 1st MTP (metatarsophalangeal)
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| What are some uncommon locations for OA | SHoulder, Thoracic Spine, Elbow, Wrist, MCP (metacarpophalangeal), Ankle, Subtalar
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| What are the 7 subsets of OA | Generalized OA, Nodal OA, Spondylosis, Erosive OA, Inflammatory OA, Diffuse idiopathic skeletal hyperostosis (DISH), Chondromalacia patellae
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| Where are heberden's nodes found | DIP
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| Where are bouchards nodes found | PIP
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| Where is the most common location to find nodes in OA | Knees 3 compartments med/lat/pat-fem
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| 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
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| 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
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| 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
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| 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)
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| What x-ray findings are indicative of OA | cartilage loss/joint space narrowing, subchondral sclerosis, osteophytes at joint margins, subchondral cysts
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| What is Genu Varus | bowleg
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| 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)
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| Who is more affected with DISH diffuse idiopathic skeletal hyperostosis | M>F
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| What other pathology is diffuse idiopathic skeletal hyperostosis (DISH) associated with | Diabetes Mellitus
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| A person with dish may develop anterior cervical osteophytes what may that cause them to have | dysphagia
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| 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)
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| What are SMOADS (systemic modulating osteoarthritic drugs) in management of OA | MMPI, Residronate, Doxycycline, Glucosamine, Chondroitin
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| 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.
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| What is the primary analgesic in management of OA | acetaminophen (3g maximum per day) easily overdosed on
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| What is the definitive tx for OA | Surgery
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| 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
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| 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
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