Osteoarthritis Overview and Causes
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Questions and Answers

What types of joints are primarily affected by osteoarthritis?

  • Weight-bearing and those affected by autoimmune responses
  • Only those in the upper body
  • Weight-bearing and those subjected to repetitive motions (correct)
  • Synovial and cartilaginous joints

Which characteristic distinguishes osteoarthritis from rheumatoid arthritis?

  • Rheumatoid arthritis primarily affects the elderly
  • Rheumatoid arthritis causes joint replacement surgery
  • Osteoarthritis is not inflammatory in nature (correct)
  • Osteoarthritis has chronic inflammation in joints

What is a common outcome of osteoarthritis in terms of patient mobility?

  • Diminished quality of life due to pain (correct)
  • Ability to walk long distances
  • Sudden onset of joint pain
  • Complete loss of joint function

Which of the following is NOT a common treatment option for osteoarthritis?

<p>Antiviral medications (C)</p> Signup and view all the answers

What diagnostic tools are typically utilized for osteoarthritis?

<p>Radiographic imaging and physical examination (A)</p> Signup and view all the answers

Which finding is expected in radiographic imaging of osteoarthritis?

<p>Joint space narrowing and osteophytes (C)</p> Signup and view all the answers

What is a significant risk factor for developing osteoarthritis?

<p>Mechanical stress from obesity (A)</p> Signup and view all the answers

What is a known secondary effect of corticosteroids in the treatment of osteoarthritis?

<p>Decreased bone density (D)</p> Signup and view all the answers

Which type of arthritis has a specific age onset range of 3-6 years?

<p>Juvenile arthritis (C)</p> Signup and view all the answers

What is the leading cause of joint replacement surgery?

<p>Osteoarthritis (D)</p> Signup and view all the answers

What is the primary first-line treatment for osteoporosis?

<p>Bisphosphonates (D)</p> Signup and view all the answers

Which group is at the highest risk for developing osteoporosis?

<p>Asian women undergoing menopause (D)</p> Signup and view all the answers

What lifestyle factor is NOT associated with an increased risk of osteoporosis?

<p>Regular weight-bearing exercise (D)</p> Signup and view all the answers

What is the typical diagnostic approach for fibromyalgia?

<p>Ruling out other conditions (C)</p> Signup and view all the answers

In fibromyalgia, which symptom is considered dominating?

<p>Fatigue (C)</p> Signup and view all the answers

Which medication is commonly used to treat pain associated with fibromyalgia?

<p>Gabapentin (D)</p> Signup and view all the answers

What is a common ocular manifestation seen in ankylosing spondylitis?

<p>Uveitis (C)</p> Signup and view all the answers

Which demographic is predominantly affected by ankylosing spondylitis?

<p>Young male adults (A)</p> Signup and view all the answers

What is the impact of estrogen decrease during menopause on osteoporosis risk?

<p>It increases the risk of fractures (B)</p> Signup and view all the answers

What is a key characteristic of fibromyalgia diagnosed following diagnostic measures?

<p>Presence of chronic pain in tender points (D)</p> Signup and view all the answers

What is a common characteristic symptom of uveitis?

<p>Photophobia (A)</p> Signup and view all the answers

Which feature is NOT typically associated with inflammatory back pain?

<p>Pain that is consistent throughout the day (A)</p> Signup and view all the answers

What is a common pharmacologic treatment for uveitis?

<p>Corticosteroids (B)</p> Signup and view all the answers

Which test is NOT useful for confirming a diagnosis of gout?

<p>Normal serum uric acid levels (C)</p> Signup and view all the answers

In ankylosing spondylitis, which demographic feature is most commonly noted?

<p>Usually starts in males aged 20-30 (C)</p> Signup and view all the answers

Which symptom is indicative of chronic gout?

<p>Presence of large tophi (A)</p> Signup and view all the answers

What is the major mechanism causing hyperuricemia in most gout cases?

<p>Renal under-excretion of uric acid (A)</p> Signup and view all the answers

Which of the following medications is commonly used as long-term management for gout?

<p>Allopurinol (B)</p> Signup and view all the answers

What complication is commonly associated with uveitis in patients with ankylosing spondylitis?

<p>Increased intraocular pressure (D)</p> Signup and view all the answers

During an acute gout attack, which laboratory finding is likely to be observed?

<p>Increased PMN's in synovial fluid (A)</p> Signup and view all the answers

Flashcards

Osteoarthritis

A common type of arthritis characterized by the progressive loss of cartilage and bone remodeling in weight-bearing or repetitive motion joints.

Osteoarthritis vs. Rheumatoid Arthritis

Osteoarthritis is a degenerative condition, not autoimmune, while rheumatoid arthritis is an autoimmune disease marked by chronic joint inflammation.

Risk Factors for Osteoarthritis

Obesity and repetitive stress on joints can increase osteoarthritis risk.

Osteoarthritis Symptoms

Joint pain, stiffness, and reduced mobility are common; advanced stages may cause inflammation.

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Osteoarthritis Diagnosis

A combination of history and physical exam, lab tests (CMP, CBC, Hepatic panel), and imaging (x-rays) help identify and differentiate it.

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Osteoporosis

A disease characterized by decreased bone density, leading to weaker bones.

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Osteoporosis Symptoms

Typically asymptomatic in initial stages. Can lead to increased risk of fractures.

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Osteophytes

Bony growths that form on the edges of joints in certain conditions, including osteoarthritis.

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Joint Space Narrowing

A common radiographic finding in osteoarthritis where the gap between bones in the joint gets smaller.

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Non-pharmacological treatment

Lifestyle changes like weight loss, physical therapy, and orthotics can help manage osteoarthritis.

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Osteoporosis Risk Factors

Factors increasing the likelihood of developing osteoporosis, a disease characterized by low bone density.

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Osteoporosis Treatment (First Line)

Bisphosphonates, like alendronate, are the initial medications used to treat osteoporosis.

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Fibromyalgia Characteristics

Fibromyalgia is a chronic condition marked by widespread pain, allodynia, fatigue, and often, psychological distress.

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Fibromyalgia Diagnosis

Fibromyalgia diagnosis is challenging, requiring a ruling out of other conditions, with lab tests often normal.

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Fibromyalgia Treatment Principles

Fibromyalgia treatment focuses on validation, conservativeness, individualized approaches, and care rather than cure.

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Ankylosing Spondylitis

A type of spondyloarthropathy, inflammatory condition affecting the spine and often other joints, affecting young adult males more frequently.

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Ankylosing Spondylitis HLA B27

HLA B27 is a marker often associated with ankylosing spondylitis, a type of spondyloarthropathy.

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Ankylosing Spondylitis Symptoms

Inflammatory back pain and stiffness, possible peripheral joint involvement, and sometimes spinal and joint fusion occurs.

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Vitamin D and Calcium

Essential for maintaining bone health to prevent brittle bones and risk of fractures.

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Central Sensitive Syndromes

A group of conditions characterized by symptoms such as pain amplification, fatigue, and varied somatic complaints. Fibromyalgia and IBS are examples.

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Ankylosing Spondylitis (AS)

A chronic inflammatory disease affecting the spine and sacroiliac joints, characterized by pain, stiffness, and potential eye involvement.

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AS Symptoms

Typically involves inflammatory back pain, morning stiffness lasting over 30 minutes, improvement with activity, and potential eye problems like uveitis. Men are more often affected.

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AS Diagnosis

Diagnosis relies on history, demographics (male predominance, young onset), lab tests (blood markers, imaging), and specific criteria.

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Gout

A type of inflammatory arthritis caused by uric acid crystals in joints. Painful, common in the big toe.

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Acute Gout Attack

Sudden, severe joint pain, often in the big toe, with redness and swelling. Pain usually starts early in the morning.

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Chronic Gout

Ongoing joint pain, stiffness, and potential formation of painful deposits (tophi) in and around joints.

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Gout Diagnosis

Diagnosis involves finding uric acid crystals in joint fluid (aspirated) and elevated serum uric acid.

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Uric Acid

Chemical compound that can crystallize and accumulate in joints, leading to gout.

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Gout Treatment (Acute)

Often involves NSAIDs (e.g., ibuprofen), corticosteroids, or colchicine to reduce inflammation and pain.

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Gout Treatment (Long-term)

Long-term management focuses on lowering uric acid levels using medications like allopurinol.

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Study Notes

Osteoarthritis

  • Typically affects weight-bearing joints and those experiencing repetitive motions
  • Characterized by progressive loss of articular cartilage and bone remodeling
  • Most common type of arthritis, especially in elderly patients
  • Rheumatoid arthritis (RA) is an autoimmune disease, unlike osteoarthritis, which is not
  • Other types of arthritis include gout and psoriatic arthritis

Osteoarthritis Causes

  • Progressive loss of articular cartilage
  • Inflammatory and autoimmune responses of chondrocytes in the articular cartilage, causing degradation of cartilage and bone remodeling
  • Leads to developing osteophytes (bone spurs)
  • Inflammation in surrounding tissue
  • Release of enzymes that break down collagen and proteoglycans (important components of cartilage)
  • Contributing factors include age, obesity, and joint injury

Osteoarthritis Symptoms

  • Joint pain, often worse with activity and improving with rest
  • Stiffness, especially after inactivity.
  • Joint swelling
  • Limited range of motion
  • Discomfort in weight-bearing joints and during repetitive motions

Osteoarthritis, Pathophysiology

  • Involves degradation of cartilage and bone remodeling due to an active response of chondrocytes in the articular cartilage
  • Initial appearance of cartilaginous bone spurs (osteophytes)
  • Cartilage degradation results in changes in consistency
  • Inflammatory cells release enzymes, degrading collagen, and destroying articular cartilage

Osteoarthritis, Diagnosis and Treatment

  • Primarily based on physical exam and patient history, rather than specific tests
  • Imaging (radiographs) might reveal joint space narrowing, osteophytes, and subchondral bone cysts
  • Treatment focuses on pain management, and minimizing further cartilage damage
  • Physical therapy, weight reduction, and bracing are often helpful.

Additional Considerations

  • Increased prevalence with age
  • Disability, decreased quality of life in older patients
  • Leading cause of joint replacement surgery
  • Can occur before age 50

Additional Joint Types of Arthritis

  • Juvenile Arthritis
  • Gout (caused by elevated uric acid levels)
  • Psoriatic Arthritis
  • Ankylosing Spondylitis (inflammation of spine)
  • Rheumatoid Arthritis (RA) (autoimmune)

Spine

  • Cervical and lumbar spine frequently show degenerative disk disease, common in those over 45 years of age.
  • Can be asymptomatic.
  • Can induce pain in the neck, head, and down the arm, with weakness or paresthesia due to nerve compression from osteophytes.

Diagnostic Imaging

  • Typically shows osteophytes (reduction of joint space), joint space narrowing, sclerosis of subchondral bone, and cysts.
  • Radionuclide bone scans and MRIs are not usually needed for diagnosis

Treatment

  • Non-pharmacologic methods, such as weight reduction, physical therapy, and orthotics (braces).
  • Pharmacologic medications may include analgesics (acetaminophen) and anti-inflammatory drugs (NSAIDs).
  • Viscosupplementation, steroid injections, or surgery may be necessary.

Osteoporosis

  • Decreased bone density, often due to aging and prolonged periods of inactivity
  • Elevated risk of fractures, especially hip, wrist, and spine fractures.
  • Contributing factors include hormonal changes (e.g. menopause) and decreased physical activity.

Gout

  • Inflammatory arthritis, usually related to high uric acid levels in the blood
  • Characterized by sudden, painful episodes of swelling and inflammation in joints. The big toe joint is most common.

Ankylosing Spondylitis

  • Chronic inflammatory condition affecting the spine and often other joints
  • Usually involves stiffness in the spine, back pain, and often progresses to fusing of the spine's bones over time.

Fibromyalgia

  • Chronic condition characterized by widespread pain, fatigue, and other symptoms
  • It is not a disorder of the joints, but one of the nerve's response to pain.
  • Diagnosis is based on patient history and physical exam.

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Description

This quiz provides an overview of osteoarthritis, including its causes, symptoms, and distinctions from other types of arthritis such as rheumatoid arthritis. It explores the mechanisms behind cartilage degeneration and the role of inflammation in joint pain. Perfect for anyone looking to understand this common condition.

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