Share your insights

Help us by sharing what content you've recieved in your exams


Osteoarthritis

Osteoarthritis is the mechanical degradation of a joint cartilage.

Risk factors

  • Primary osteoarthritis risk factors
    • Increasing age
    • Obesity
    • Family history
    • Female gender
    • Sports activities
  • Secondary osteoarthritis causes
    • Pre-existing joint damage: trauma, RA, gout, spondyloarthropathy, septic arthritis, Paget’s disease, avascular necrosis
    • Metabolic disease: chondrocalcinosis, haemochromatosis, acromegaly
    • Systemic disease: haemophilia (haemarthrosis), neuropathy, haemoglobinopathy

Clinical features

Symptoms

  • Joint pain: worse on exercise and relieved by rest, morning pain <30 minutes
  • Commonly affected joints: knees, hips, interphalangeal joints of fingers, carpometacarpal joint of thumb

Signs

  • Crepitus
  • Pain on movement
  • Reduced range of movement
  • May be bony swellings (osteophytes), joint instability, joint effusions
  • Characteristic hand deformities: Heberden’s nodes, Bouchard’s nodes, squaring of carpometacarpal joint of thumb

Investigations

  • X-Rays 
  • Bloods: FBC, CRP/ESR
    • Only useful for ruling out inflammatory and infectious causes (inflammatory markers not raised in osteoarthritis)

Management

  • Conservative: exercise, physiotherapy, weight loss, mobility aids, supportive footwear
  • Analgesia: topical NSAID, then oral NSAID if required
  • Intra-articular corticosteroid injections
  • Joint replacement aims to reduce pain and improve mobility

Reference: NICE β€˜NG226 Osteoarthritis in over 16s: diagnosis and management’ 2022

Questions for you

What are the classical features of osteoarthritis on an X-ray?

Oops! This section is restricted to members. Click here to signup!

What are the possible complications of joint replacement?

Oops! This section is restricted to members. Click here to signup!

What is capsaicin? How does it work? What is a common adverse effect?

Oops! This section is restricted to members. Click here to signup!

Try some OSCE stations!

  1. Knee osteoarthritis exam
  2. Hip exam
  3. Foot and ankle exam
  4. Hand and wrist exam
  5. Find lots more here

No comments yet πŸ˜‰

Leave a Reply