Osteoarthritis
Definition
Erosion of articular cartilage, leading to joint destruction
Epidemiology
Risk Factors
Clinical Features
Symptoms
Signs
Investigations
Bloods:
Imaging:
Treatment
Non pharm
Pharm
Surgery
Source
Dr Alasdair MacDonald 2014
Erosion of articular cartilage, leading to joint destruction
Epidemiology
- FHX (Type 2 collagen gene)
- F>M
- 70% @ 40y, 100% @ 75y
Risk Factors
- ***Weight
- Female (3-4x)
- Trauma
- Diabetes (?metabolic disease --> calcium phosphate metabolism)
Clinical Features
Symptoms
- Post activity pain, stiffness (<15min)
Signs
- Heberdens and Bouchards nodes (B is closer to Body)
- Reduced ROM
- Minor swelling and deformity (Usually DIP, PIP, 1st MCP, back, hips, knees, ankle)
- Antalgic gait
- No effusions
- Palpable crepitations
Investigations
Bloods:
- FBC (WCC <200)
Imaging:
- X ray (loss of joint space, subchondral cysts, subarticular sclerosis, osteophytes)
Treatment
Non pharm
- Education
- Weight loss
- Physio, hydrotherapy, exercise (only no evidence for gout)
- OT
- Pain Mx (TENS)
- Acupuncture
Pharm
- Paracetamol
- Tpoical analgesics (Voltaren gel, capsaicin)
- NSAIDs (+/- PPI)
- Intra-articular steroids
- Intra-articular hyaluronic acid (artificial synovial fluid) and chondrocyte implantation
- Opioids (Norspan)
Surgery
- Joint lavage
- Arthroscopic debridement
- Osteotomy (change bone mechanics/ use less diseased areas of joint)
- Joint replacement
Source
Dr Alasdair MacDonald 2014