Osteoarthritis Overview and Risk Factors
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Questions and Answers

What is a hallmark feature of the early stages of rheumatoid arthritis (RA)?

  • Extreme bone erosion visible on X-ray
  • Significant joint deformity
  • Thickening and inflammation of the synovium (correct)
  • Elevated bone density levels

    • Which statement accurately reflects the potential effects of biological DMARDs?

  • They have no significant side effects.
  • They are safe to use with live vaccines.
  • They are the first-line treatment for pain management.
  • They can target specific immune pathways. (correct)

    • What is a common clinical manifestation of rheumatoid arthritis?

  • Rapid onset of moderate joint swelling
  • Unilateral joint pain
  • Morning stiffness lasting over 30 minutes (correct)
  • Extreme joint mobility without pain

    • In the moderate stage of rheumatoid arthritis, which of the following is observed?

    <p>Development of connective tissue in inflamed areas (C)</p> Signup and view all the answers

    What is a significant risk factor for developing rheumatoid arthritis?

    <p>Environmental and genetic factors (A)</p> Signup and view all the answers

    What is reflected in lab tests used to confirm rheumatoid arthritis?

    <p>Non-specific indicators like C-reactive protein (CRP) (D)</p> Signup and view all the answers

    Which management approach is typically used for rheumatoid arthritis?

    <p>A balanced regimen of rest and exercise cycles (C)</p> Signup and view all the answers

    Which of the following describes a feature of severe rheumatoid arthritis?

    <p>Extensive joint damage and significant pain (B)</p> Signup and view all the answers

    Which cytokines play a crucial role in the pathology of rheumatoid arthritis?

    <p>Cytokines that cause systemic inflammation (B)</p> Signup and view all the answers

    What differentiates rheumatoid arthritis from osteoarthritis?

    <p>RA is a systemic autoimmune disease (D)</p> Signup and view all the answers

    What is a characteristic change observed in cartilage during osteoarthritis?

    <p>Cartilage becomes yellow and granular. (B)</p> Signup and view all the answers

    Which of the following is NOT considered a risk factor for developing osteoarthritis?

    <p>Greater muscle mass (D)</p> Signup and view all the answers

    Which type of joint is primarily affected by osteoarthritis according to its definition?

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

    What is the most beneficial first approach to managing osteoarthritis?

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

    What is a significant clinical manifestation of osteoarthritis related to joint movement?

    <p>Pain that increases with movement (A)</p> Signup and view all the answers

    Which of the following methods is least likely to be used for evaluating osteoarthritis?

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

    What are the primary changes observed in osteoarthritis associated with bone structure?

    <p>Formation of micro-cracks and osteophytes (D)</p> Signup and view all the answers

    Which of the following options best describes a common characteristic of joint stiffness due to osteoarthritis?

    <p>Most noticeable in the morning (D)</p> Signup and view all the answers

    When evaluating the functional limitations caused by osteoarthritis, which of the following aspects is NOT typically assessed?

    <p>Blood pressure levels (B)</p> Signup and view all the answers

    Which pharmacologic agent is commonly used for mild to moderate osteoarthritis pain management?

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

    Flashcards

    Osteoarthritis (OA)

    A progressive joint disease causing cartilage deterioration and pain.

    Synovial Joint

    A type of joint with a synovial membrane, cartilage, fluid, and capsule.

    Cartilage in OA

    Cartilage degrades, becoming rough and causing increased friction in osteoarthritis.

    Clinical Manifestations of OA

    Common symptoms include pain (especially with movement), stiffness (especially morning), crepitus (grating sound), and potential bone spur formations.

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    Commonly Affected Joints (OA)

    Joints bearing heavy loads, such as knees, hips, hands, and spine, are often affected by osteoarthritis.

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    OA Risk Factors

    Factors increasing OA risk include age, obesity, trauma, genetic predisposition, and hormonal changes.

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    Conservative OA Management

    Non-surgical approaches to treat osteoarthritis, including rest, physical therapy, and pain management.

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    Surgical OA Management

    Surgical interventions used for severe or resistant cases of osteoarthritis.

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    Pharmacologic OA Management

    Medication approaches for osteoarthritis, ranging from acetaminophen to NSAIDs.

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    X-ray in OA Evaluation

    X-rays assess joint space narrowing, subchondral sclerosis (bone hardening), and bone spurs (osteophytes).

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    Rheumatoid Arthritis (RA)

    A systemic autoimmune disease causing inflammation in synovial joints, often disabling.

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    Autoimmune Theory of RA

    Activation of macrophages releases cytokines, causing inflammation and joint damage in RA.

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    Early Stage of RA

    Synovium (joint lining) thickens, inflames, and fibrin accumulates, causing stiffness, pain, and reduced movement.

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    Moderate Stage of RA

    Synovium thickens further, inflammation increases. Connective tissue develops, causing functional impairments.

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    Severe Stage of RA

    Extensive joint damage, bone density decrease, cartilage destruction occurs, leading to deformities and significant pain.

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    ESR and CRP

    Non-specific lab tests used to assess inflammation, often elevated in RA.

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    Rheumatoid Factor (RF)

    A blood test, often elevated in rheumatoid arthritis.

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    Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

    Drugs that suppress the immune system, used in RA to reduce inflammation and progression.

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    Methotrexate

    A DMARD used early in RA treatment, often the starting point for DMARD treatment.

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    Study Notes

    Osteoarthritis

    • Progressive, degenerative disease of the joints
    • Most commonly affects hips, knees, hands (constantly load bearing)
    • May be secondary to a condition or trauma, but many cases have no single cause
    • Considered the most common form of arthritis
    • Age, obesity, injury, joint overuse are risk factors
    • Genetic traits, previous injuries (e.g., meniscus tears or ligament strains) also play a role

    Risk Factors

    • Age
    • Obesity
    • Trauma (might kill more stress on the joints)
    • Overuse of the joint
    • Genetic traits (degeneration decreasing overtime, child birth, bone changes, biomechanical load is different)

    Synovial Joint Structure

    • Synovial fluid is key for the joints in the body
    • Synovial fluid is important for reducing friction, supporting the nourishment of the cartilage
    • Cartilage is created by chondrocytes important for maintaining the cartilaginous matrix

    Cartilage Osteoarthritis

    • Cartilage becomes yellow, dull, and granular, increasing friction between bones
    • Chronic inflammation of the joint

    Clinical Manifestations

    • Pain (gradually present or uncertain) (Early changes in symptomatic OA), stiffness, and limited range of motion (especially in the morning)
    • Joint creaking or grinding.
    • Swelling in the joint
    • Tenderness to the touch
    • Difficulty with movement.
    • Bone spurs (outgrowths of bone that occur near the joint) or cysts

    Early Changes in OA

    • Healthy joint: smooth, articular cartilage, which provides a cushioned surface for smooth bone movement
    • Later changes in OA: decrease in the thickness of the articular cartilage, increased production of synovial fluid, and development of bone spurs or cysts

    Review of Hand Joints

    • Carpal bones form the wrist joint
    • Bone cyst is a hollow part of bone
    • Bone spur is the bump in joint.

    OA Commonly Affected Joints

    • Joints that bear the most heavy load (e.g., knees, hips, spine)
    • All body weight and movements also affect the joints in the back (spine), shoulders, hips

    Evaluation

    • History (everything has been going on in factor, joint stiffness, functional limitations, previous injuries?)
    • Physical Exam (palpate/observe joint involvement, assess tenderness, range of motion)
    • X-ray
    • Blood tests

    Management (Conservative)

    • Non-pharmacological therapy
    • Balance rest and activity (exercise has to be similar function to avoid problems)
    • Medications to reduce inflammation (mild anti-inflammatory drugs or supplements)
    • Heat or cold application

    Management (Surgical)

    • Medications that reduce inflammation
    • Joint replacement (e.g., arthroplasty)

    Management (Drugs)

    • Cyclooxygenase inhibitors (COX inhibitors) (moderate to severe), e.g., NSAIDs, topical (if only a few joints are involved).

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    Description

    This quiz covers osteoarthritis, a progressive disease affecting joints, including risk factors such as age, obesity, and trauma. Learn about the structure of synovial joints and the role of cartilage in osteoarthritis. Test your understanding of this common form of arthritis and its implications.

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