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Osteoarthritis (Epidemiology (The MOST COMMON types of arthritis, The most…
Osteoarthritis
Epidemiology
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Secondary OA occurs in joint disease or other conditions e.g. haemochromatosis, obesity and occupational
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An age-related, dynamic reaction pattern of a joint in response to insult or injury
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Risk Factors
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Increasing age - cumulative effect of traumatic insult, decline in neuromuscular function
Obesity - not due to mechanical factors, obesity is a pro-inflammatory state
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Occupation - manual labor & small hand joints, farming & hips, football & knees
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Clinical Presentation
Crepitus (grating) - crunching sensation when moving joint due to the disruption of the normally smooth articulating surfaces of the joints
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Affects many joints, typically causing mechanical pain with movement and/or loss of function
Diagnosis
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Aspiration of synovial fluid if there is a painful effusion - this shows viscous fluid with few leucocytes
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Key Facts
Inflammation of articular (actually in contact with bone) and periarticular structure and alteration in cartilage structure
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Treatment
Pharmacological
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Intra-articular corticosteroid injections produce short-term improvement when there is a painful joint effusion
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Surgery
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Arthroscopy
Scope inserted into joint to assess damage and remove loose bodies e.g. bone or cartilage fragment that causes 'knee lock' - this is the only indication for arthroscopy in osteoarthritis
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Non-medical
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Bracing devices, joint supports, insoles for joint stability and footwear with shock-absorbing properties for lower limbs
Acupuncture, physiotherapy and occupational therapy
Excerise to improve local muscle strength, improve mobility of weight bearing joints and general aerobic fitness
Pathophysiology
Progressive destruction and loss or articular cartilage with an accompanying periarticular bone response
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Differential Diagnosis
Differentiated from rheumatoid by the pattern of joint involvement and the absence of systemic features and
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