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Osteoarthritis, prevalence (20% of over 45s, 1%), pathophys (non…
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pathophys
non-inflammatory
tear, flare, repair
inflammatory
bony erosions, pannus effusions
risk factors
injury, age, obesity, activity
F, genetic, smoking, AI, ?diet
joints
monoarthritis
BIG (+some small), knee, hip, shoulder, fingers (DIP, PIP)
symmetrical poyarthritis
SMALL PIP, MCP
stiffness and pain
all day, increases after exercise
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examination
Bouchard's nodes (PIP), Heberden's (DIP),
decreased range of movement, crepitus, tenderness
swan-necking, Boutonniere's nodules,
swelling and heat, ulnar deviation, Z-thumb
investigations
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bloods
Rh (+ve in 70%)
anti-CCP (confirms)
CRP, ESR, plts
(x-ray)
symptom management
weight loss, exercise, NSAIDs, analgesia, steroid injections
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disease modification
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DMARD (methotrexate, sulfasalazine, hydrozychloroquine), IM gold, biologics
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