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Osteo And Rheumatoid Arthritis Notes

This is a sample of our (approximately) 3 page long Osteo And Rheumatoid Arthritis notes, which we sell as part of the Rheumatology Notes collection, a MBChB (hons) (1st) package written at University Of Leicester in 2014 that contains (approximately) 20 pages of notes across 6 different documents.

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Osteoarthritis A progressive degenerative condition of the synovial joints characterized by cartilage loss and accompanying peri-articular bone response. Females>Males Usually >50 years Risk Factors Female, obesity, high bone density, trauma, occupation, genetic factors Pathogenesis 1) Progressive cartilage damage results in loss of cartilage 2) Reactive bony hypertrophy adjacent to cartilage loss = osteophytes 3) Underlying subchondral bone may remodel leading to subchondral cyst formation + sclerosis Classification
- Primary OA (most common)
- Secondary OA (2nd to trauma, inflammatory arthritis, metabolic disorders) Clinical features (symptoms)
- Joint pain o Agg. By activity relieved by rest o Worse at end of day o Interferes with sleep
- Stiffness o Minor in morning, reoccurs following periods of rest (swelling)
- Loss of function

Signs
- Crepitus
- Limitation of movement
- Joint instability
- Joint effusion
- Muscle wasting Heberden's nodes over DIPJs Bauchard's nodes over PIPJs

Joints most affected
- DIPJs
- Hips
- Knees
- C + L spine Investigations CRP mildly elevated Plain radiograph

Management Non-pharmacological
- Education
- Exercise
- Weight loss
- Orthotic devices (insoles, sticks)

Loss of joint space Subcondral sclerosis Subchondral/periarticular cysts Osteophytes Pharmacological
- Analgesics (work up)
- Capsaicin cream - topically applied) Intra-articular injections
- Corticosteroid + LA Surgery
- Arthroscopy + washout
- Osteotomy
- Joint replacement (excellent outcome in 95%) Function > 15yrs. Loss of pain.

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