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Osteo And Rheumatoid Arthritis Notes

Medicine Notes > Rheumatology Notes

This is an extract of our Osteo And Rheumatoid Arthritis document, which we sell as part of our Rheumatology Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Rheumatology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

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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