Download osteo arthritis

OSTEO ARTHRITIS
BY
DR WAQAR
OSTEOARTHRITIS
It is a degenerative arthritis involving synovial
joints.
1) It is the most common type of arthritis
2) More common after age 60
3) Most cases are idiopathic (primary
osteoarthritis) with no know cause
4) Can occur in young ppl if there is any joint
damage from before, or fracture thru a joint, or
mal-alignment of bones ( secondary O.A.)
PATHOGENESIS
1) There is progressive“damage & loss” of joint
cartilage
2) The sub-chondral bone, which is exposed,
gets sclerotic & develops cysts
3) “Osteophytes” form at the joint margins
(spur like structures)
4) Cartilage damage is due to release of
enzymes which destroy the collagen
INFLAMMATION IN THE JOINTS IS VER MINIMAL.
IT IS MAINLY A “DEGENERATIVE” JOINT DISEASE
O.A. (contd.)
WHICH JOINTS ARE AFFECTED?
Most commonly affected are:
1) DIP joints
2) 1st carpometacarpal jt( base of the thumb)
3) Wt. bearing joints( spine, hip, knees)
4) 1st metatarso-phalangeal jt.of the foot (toe)
Commonest Joints affected by :
a) Gout: ? b) CPPD: ? c) OA: ?
d) R.A. : ?
Predisposing factors for O.A.
1) Old age
2) Obesity
3) Pre-existing joint abnormalities, fracture thru
a joint, & mal-aligned bones ( occurs due to
malunited fractures)
1)
2)
3)
4)
5)
SIGNS/ SYMPTOMS
Joint pain ( more with movement)
Joint becomes stiff after resting ( gelling)
Morning stiffness less than ½ hr. ( > 1 hr. in R.A)
Muscle wasting around the joint
Crepitus( cracking sound) during joint motion
6) Joint deformity:
* Heberden’s nodes in DIP jts.
* Bouchard’s nodes in PIP jts.
INVESTIGATIONS
1) X-Rays:
* Joint space narrowing
* Subchondral bone sclerosis & cysts
*Osteophytes
2) Blood tests are normal. Rheumatoid fac. neg.
TREATMENT
1) Patient education 2) Guided exercises
3) Support things( stick, walker etc)
4) Analgesics( panadol, NSAIDs etc)
5) In case of a painful joint effusion, can give intra-articula
steroid inj. Otherwise, no role of steroids
6) Hip /knee replacement surgery
REMEMBER
ALLAH HAS MADE SALAAT COMPULSORY 5
TIMES A DAY
BUT
HE HAS MADE “GOOD AKHLAAQ” COMPUL-SARY 24 HRS A DAY !