Understanding Osteoarthritis
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Questions and Answers

What is the primary pathological process involved in osteoarthritis?

  • Systemic inflammation of multiple joints
  • Autoimmune attack on joint tissues
  • Progressive destruction of articular cartilage and subchondral bone (correct)
  • Infection of the synovial fluid

Which of the following best describes the nature of osteoarthritis?

  • A rapidly progressing autoimmune disorder targeting the joints.
  • An infectious disease causing joint degeneration.
  • A noninflammatory, localized, progressive joint disease. (correct)
  • An inflammatory condition affecting multiple organ systems.

A 60-year-old female patient presents with joint pain. Which of the following joints is most likely to be affected by osteoarthritis, based on prevalence?

  • Hip joint (correct)
  • Temporomandibular joint
  • Metacarpophalangeal joint of the thumb
  • Ankle joint

Given the localized nature of osteoarthritis, what is a likely clinical presentation?

<p>Pain primarily in one or a few joints. (A)</p> Signup and view all the answers

What is typically the primary reason a patient with osteoarthritis seeks medical attention?

<p>Joint pain. (B)</p> Signup and view all the answers

Which demographic is most likely to be affected by osteoarthritis?

<p>Women over 50 years old (B)</p> Signup and view all the answers

In the progression of osteoarthritis, what changes occur in the subchondral bone?

<p>Formation of osteophytes and sclerosis (B)</p> Signup and view all the answers

What is the significance of the noninflammatory nature of osteoarthritis compared to other forms of arthritis?

<p>It distinguishes the underlying disease process and treatment approach. (C)</p> Signup and view all the answers

If a patient presents with osteoarthritis localized to a single joint, what does this indicate about the nature of the disease?

<p>Osteoarthritis can manifest in a localized or generalized manner. (B)</p> Signup and view all the answers

Considering the prevalence data, which of the following patients is LEAST likely to have osteoarthritis?

<p>A 30-year-old woman with hand pain following a recent injury (D)</p> Signup and view all the answers

Which of the following is NOT typically associated with the subjective clinical presentation of osteoarthritis?

<p>Rapid onset of joint erythema and warmth. (D)</p> Signup and view all the answers

A patient reports knee pain and instability, with occasional buckling. During a physical exam, what objective finding would MOST strongly suggest osteoarthritis as the cause?

<p>Bony swelling and limited range of motion. (D)</p> Signup and view all the answers

Which differential diagnosis is LEAST likely to be confused with osteoarthritis due to its distinct clinical presentation?

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

What is the PRIMARY purpose of ordering X-rays in the diagnostic workup of osteoarthritis?

<p>To identify joint space narrowing and osteophytes. (B)</p> Signup and view all the answers

A patient with osteoarthritis has failed to respond adequately to acetaminophen and topical treatments. Considering the guidelines of pharmacological management, what is the NEXT most appropriate step?

<p>Initiation of oral NSAIDs, considering GI risk. (C)</p> Signup and view all the answers

What is the MOST appropriate rationale for recommending weight loss to an overweight patient diagnosed with osteoarthritis?

<p>To reduce joint stress and improve functional capacity. (A)</p> Signup and view all the answers

Which of the following non-pharmacological interventions aims to provide joint stability during exercise?

<p>Knee or elbow braces. (D)</p> Signup and view all the answers

An elderly patient with osteoarthritis presents with increased pain and stiffness. Which of the following factors would be MOST important to consider when developing a treatment plan?

<p>The patient's overall health, comorbidities, and potential for drug interactions. (B)</p> Signup and view all the answers

A patient with osteoarthritis of the knee reports difficulty performing daily activities due to pain. Besides pain medication, which intervention would BEST address the patient's functional limitations?

<p>Referral to a physical therapist for muscle strengthening exercises. (A)</p> Signup and view all the answers

A patient with osteoarthritis asks about alternative therapies. Which approach has some evidence to suggest potential benefit in managing OA symptoms?

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

Which of the following pre-existing conditions would MOST significantly increase an individual's risk of developing osteoarthritis later in life?

<p>History of developmental dysplasia of the hip. (A)</p> Signup and view all the answers

A patient with osteoarthritis reports increased social isolation. Which of the following is the MOST likely contributing factor to this issue?

<p>Difficulty participating in social activities due to chronic pain and limited mobility. (B)</p> Signup and view all the answers

Why does osteoarthritis pain typically worsen in the late afternoon and early evening?

<p>The cumulative effect of joint use throughout the day exacerbates the pain. (C)</p> Signup and view all the answers

What is the MOST likely reason for the buckling or 'giving way' sensation reported by some patients with knee osteoarthritis?

<p>Weakness in the quadriceps muscles and altered joint biomechanics. (B)</p> Signup and view all the answers

During a physical exam of a patient with suspected osteoarthritis, which finding would suggest more advanced joint damage rather than an early stage of the disease?

<p>Significant bony protuberances and abnormal joint angulation. (D)</p> Signup and view all the answers

When assessing a patient's gait, what observation would be MOST indicative of altered patellar tracking due to osteoarthritis?

<p>Visible shift of the patella as the leg bends and straightens. (A)</p> Signup and view all the answers

A patient presents with joint pain and swelling primarily in the MTP joint of the big toe. Which of the following is the MOST important differential diagnosis to consider and rule out?

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

When reviewing X-ray results for a patient with suspected osteoarthritis, which radiographic finding is MOST indicative of the disease?

<p>Presence of osteophytes and joint space narrowing. (C)</p> Signup and view all the answers

Why are oral NSAIDs typically considered first-line therapy in the pharmacological management of osteoarthritis?

<p>They effectively reduce both pain and inflammation associated with osteoarthritis. (C)</p> Signup and view all the answers

Beyond pain relief, what is a primary goal of non-pharmacological interventions in the management of osteoarthritis?

<p>To minimize reliance on medications with potential side effects and improve joint support. (A)</p> Signup and view all the answers

Which of the following processes characterizes the pathophysiology of osteoarthritis?

<p>Progressive degradation of articular cartilage with subchondral bone changes (A)</p> Signup and view all the answers

What differentiates osteoarthritis from many other forms of arthritis?

<p>Its localized and primarily noninflammatory nature (B)</p> Signup and view all the answers

A 55-year-old male presents with joint pain that has gradually worsened over several years. Considering the common sites affected by osteoarthritis, which joint location would be LEAST likely as the primary source of his pain?

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

If a patient is diagnosed with osteoarthritis affecting only one knee joint, what can be inferred about the disease based on its typical characteristics?

<p>The disease is localized, but could potentially generalize over time. (D)</p> Signup and view all the answers

A patient with osteoarthritis reports experiencing pain primarily during weight-bearing activities and at the end of the day. Which pathological feature of osteoarthritis is MOST directly contributing to this patient's pain pattern?

<p>Erosion of cartilage and increased bone-on-bone contact (D)</p> Signup and view all the answers

Considering the prevalence of osteoarthritis in the population, which individual is at the HIGHEST risk of developing the condition?

<p>A 60-year-old obese female (C)</p> Signup and view all the answers

In the later stages of osteoarthritis, changes occur in the subchondral bone. What is the body's MOST LIKELY response in this area?

<p>Subchondral sclerosis due to increased bone density (A)</p> Signup and view all the answers

How does the noninflammatory characteristic of osteoarthritis influence its clinical management compared to rheumatoid arthritis?

<p>It allows for a greater emphasis on pain management and functional improvement strategies. (B)</p> Signup and view all the answers

A 62-year-old patient presents with hip pain diagnosed as osteoarthritis. She asks about the likelihood of developing the disease in other joints. What would be the MOST appropriate response, based on the nature of osteoarthritis?

<p>The disease is localized but may generalize, so other joints could potentially be affected in the future. (C)</p> Signup and view all the answers

A primary care provider (PCP) is evaluating several patients with joint pain. Which patient presentation would MOST STRONGLY suggest a diagnosis OTHER than osteoarthritis?

<p>A 40-year-old with acute onset of pain, swelling, and redness in multiple joints. (B)</p> Signup and view all the answers

Which of the following characteristics is MOST indicative of osteoarthritis?

<p>Progressive cartilage destruction with subchondral bone changes localized to affected joints (D)</p> Signup and view all the answers

A patient presents with pain primarily in their hip and knee joints. Given the information, which condition is MOST likely?

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

Which statement BEST describes the distribution pattern of osteoarthritis?

<p>Can be localized to a single joint, involve a few joints, or be generalized (C)</p> Signup and view all the answers

What is the underlying process in osteoarthritis that leads to joint pain?

<p>The formation of bone spurs, cartilage loss, and subsequent nerve irritation (C)</p> Signup and view all the answers

Why is osteoarthritis classified as a noninflammatory joint disease?

<p>Because it primarily involves mechanical wear and tear rather than an immune response (A)</p> Signup and view all the answers

An 55-year-old patient is diagnosed with osteoarthritis. Which factor MOST likely contributed to this diagnosis based on the provided information?

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

A 62-year-old female patient presents with joint pain. What is the MOST likely initial treatment approach, considering the nature of osteoarthritis?

<p>Providing pain management and lifestyle modifications (A)</p> Signup and view all the answers

In a patient with osteoarthritis, which of the following findings on an X-ray would be MOST indicative of the disease?

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

A 70-year-old male presents with osteoarthritis in his knees. Besides pain, what other symptom is he MOST likely to experience that would impact his daily activities?

<p>Limited range of motion and stiffness (C)</p> Signup and view all the answers

What is the MOST likely reason for increased prevalence of Osteoarthritis in women compared to men, according to this content?

<p>Specific hormonal factors influence joint health (D)</p> Signup and view all the answers

Which of the following factors contributes MOST significantly to the progression of osteoarthritis due to altered joint biomechanics?

<p>Prolonged used or overuse of joints (C)</p> Signup and view all the answers

A patient with osteoarthritis reports experiencing increased pain in the late afternoon and early evening. What is the MOST likely contributing factor to this specific pain pattern?

<p>Cumulative joint stress and fatigue over the course of the day (C)</p> Signup and view all the answers

A patient presents with knee pain and reports occasional 'buckling' or 'giving way'. What underlying mechanism is MOST likely responsible for this sensation in the context of osteoarthritis?

<p>Weakness in the supporting muscles around the joint (D)</p> Signup and view all the answers

During a physical examination of a patient with suspected osteoarthritis, which of the following findings would suggest a more advanced stage of the disease?

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

A patient presents with joint pain primarily in the MTP joint of the big toe. Besides gout, what other differential diagnosis should be strongly considered and ruled out?

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

Beyond pain relief, what is a primary goal of incorporating non-pharmacological interventions to manage osteoarthritis?

<p>To improve joint function and maintain mobility (C)</p> Signup and view all the answers

What is the primary characteristic that differentiates osteoarthritis from other joint diseases?

<p>Localized joint degeneration with minimal inflammation (A)</p> Signup and view all the answers

A patient presents with pain limited to their right knee and left hip. Based on the nature of osteoarthritis, what is the MOST likely classification?

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

Which of the following factors contributes MOST significantly to the progressive destruction of articular cartilage in osteoarthritis?

<p>Mechanical stress and degradation of the cartilage matrix (B)</p> Signup and view all the answers

Considering the prevalence data, which patient is MOST likely to initially present with osteoarthritis?

<p>A 60-year-old female with a history of knee injuries (D)</p> Signup and view all the answers

A patient is diagnosed with osteoarthritis. The X-ray report mentions 'osteophyte formation.' What process does this finding indicate?

<p>The body's attempt to stabilize the joint by creating bony outgrowths (A)</p> Signup and view all the answers

A researcher is studying the biomechanics of osteoarthritis. Which aspect of joint function is MOST relevant to the progression of the disease?

<p>The distribution and magnitude of mechanical loads on the articular cartilage (A)</p> Signup and view all the answers

A patient is being evaluated for possible osteoarthritis. Which subjective symptom would MOST strongly suggest osteoarthritis?

<p>Joint pain that worsens with activity and improves with rest (B)</p> Signup and view all the answers

How does subchondral bone sclerosis contribute to the pathophysiology of osteoarthritis?

<p>It alters joint mechanics, leading to increased stress on the articular cartilage (A)</p> Signup and view all the answers

A patient presents with osteoarthritis in multiple joints, including the hands, knees, and hips. What is the MOST likely contributing factor to this widespread presentation?

<p>Generalized osteoarthritis due to a combination of genetic predisposition and mechanical stress (C)</p> Signup and view all the answers

Considering the pathophysiology of osteoarthritis, how does the breakdown of articular cartilage DIRECTLY lead to pain?

<p>By exposing nerve endings in the subchondral bone (D)</p> Signup and view all the answers

Which of the following factors is LEAST likely to be a direct risk factor for the development of osteoarthritis?

<p>High-intensity, short duration exercise. (D)</p> Signup and view all the answers

A patient with osteoarthritis reports experiencing increased social isolation. Which of the following is the MOST likely contributing factor to this issue?

<p>Reduced mobility and chronic pain. (A)</p> Signup and view all the answers

What is the MOST likely reason for increased joint pain in the late afternoon and early evening for individuals with osteoarthritis?

<p>Cumulative joint use and stress throughout the day. (D)</p> Signup and view all the answers

A patient presents with bony enlargements at the distal interphalangeal (DIP) joints. Which of the following clinical findings is MOST consistent with these observations in the context of suspected osteoarthritis?

<p>Heberden's nodes. (A)</p> Signup and view all the answers

During a physical examination of a patient with suspected osteoarthritis of the knee, which finding would suggest significant progression of the disease?

<p>Gross joint deformity with abnormal angulation. (A)</p> Signup and view all the answers

When assessing a patient's gait, which observation would MOST strongly suggest altered patellar tracking secondary to osteoarthritis?

<p>Visible shift of the patella as the leg bends and straightens. (A)</p> Signup and view all the answers

Which of the following is the MOST important differentiating factor between osteoarthritis and rheumatoid arthritis based on clinical presentation?

<p>Rheumatoid arthritis commonly involves multiple joints, particularly smaller ones. (C)</p> Signup and view all the answers

In the diagnostic process for osteoarthritis, what is the PRIMARY reason for obtaining X-ray imaging of the affected joint?

<p>To assess the extent of cartilage damage and presence of osteophytes. (A)</p> Signup and view all the answers

A patient with osteoarthritis of the knee has not responded well to initial treatments. Considering pharmacological options, what factor would MOST strongly suggest trialing a topical NSAID before oral medications?

<p>Patient has a history of peptic ulcer disease. (C)</p> Signup and view all the answers

Besides medication, which of the following non-pharmacological interventions is MOST directly aimed at improving joint stability in a patient with osteoarthritis?

<p>Muscle strengthening exercises. (C)</p> Signup and view all the answers

Flashcards

OA Joint Pain

Cartilage wears away, tendons and ligaments stretch causing this.

OA Limited ROM

Limited range of motion caused by osteophytes and capsular thickening.

OA Bone Swelling

Bone remodeling and osteophytes cause this.

OA Joint Deformity

Abnormal joint angulation or subluxation signifies advanced joint damage.

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OA Instability

Knee buckling or patellar shifts during movement indicate this issue.

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OA Pharmacological Treatment

NSAIDs, COX-2 inhibitors, topical NSAIDs, corticosteroid injections

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OA Non-Pharmacological Treatment

Orthotics, cane, sling, weight loss, muscle strengthening, heat/cold therapy

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OA Diagnostic Findings

Joint space narrowing and osteophytes on imaging.

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OA Subjective Symptoms

Morning stiffness that loosens with movement, pain worse with joint use, relieved by rest

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OA Objective Signs

Bony enlargement from osteophytes, e.g. Heberden's and Bouchard's nodes.

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Osteoarthritis Definition

Progressive breakdown of joint cartilage and underlying bone.

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Osteoarthritis Characteristics

Characterized by joint pain, stiffness, and reduced range of motion; noninflammatory.

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Common OA Locations

Hands, knees, hips, and feet; typically weight-bearing joints.

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OA Joint Distribution

Localized to a single joint, a few joints, or widespread based on the individual.

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Primary OA Symptom

Joint pain that prompts the patient to seek medical care.

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OA Prevalence

The most prevalent joint disorder in the United States.

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OA Gender Predisposition

More common in women than men.

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OA Onset Age

Incidence increases significantly after 50 years old.

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US OA Cases

Affects more than 30 million individuals in the U.S.

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Osteophyte Formation

Formation of bone spurs around affected joints.

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OA and Obesity

Increased weight adds stress to joints.

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OA Risk Factors: Trauma

Joint disease, injury, or deformities predispose to OA.

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OA and Depression

An emotional consequence that often accompanies OA.

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OA and Loss of Intimacy

A potential outcome of OA that affects relationships.

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OA Stiffness Pattern

Morning stiffness that improves with movement.

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OA and Knee Buckling

Knee may unexpectedly give way.

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OA Differential Diagnosis

Rule out similar conditions with overlapping symptoms.

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OA: Joint Space Narrowing

Narrowing of the space within the joint.

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OA Pain Management: Tramadol

Used briefly for severe OA exacerbations.

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OA: Non-drug Therapies

Weight loss, exercise, braces

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Osteoarthritis Pathology

Progressive deterioration of articular cartilage and subchondral bone, accompanied by osteophyte formation and sclerosis.

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Osteoarthritis Type

A localized, noninflammatory, progressive form of joint disease.

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OA - Commonality

The most frequently occurring type of arthritis.

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OA Joint Spread

Can affect a single joint, a small set, or have a widespread distribution.

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OA Pain

The primary reason patients with OA seek medical care.

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OA Prevalence (US)

The most common joint disease within the United States.

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OA Gender

Higher occurrence rate in women than men.

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OA Age

Incidence increases with age; common over 50 years old.

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OA - US Cases

Affects over 30 million individuals within the U.S.

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OA Common Sites

Hands, knees, feet and hips.

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OA Pathology

Progressive breakdown of cartilage and bone in joints, accompanied by bone spur formation and hardening of bone.

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OA: Joint Type

A joint condition characterized by localized, non-inflammatory and progressive joint damage.

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OA Pain Driver

The main reason people seek medical help for Osteoarthritis.

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OA Prevalence - US

The most common joint disease in the United States.

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OA Gender Impact

More frequently affects women compared to men.

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OA Age Onset

Increased incidence with advancing years, typically after age 50.

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OA Common Areas

Frequently involves hands, knees, feet and hips.

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OA: Trauma

A potential cause or risk factor of OA related to joint damage.

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OA and Intimacy

Reduced physical ability impairs connection with one's partner.

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Rheumatoid Arthritis

Systemic disease involving multiple joints, starting with smaller ones.

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Gout

Condition mainly affecting the big toe joint, linked to high uric acid.

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Joint Injury

Localized joint pain due to tendon or ligament injury.

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Osteoporosis

Weak bones prone to fracture because of Vitamin D deficiency.

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Tendinitis

Inflammation of tendons caused by sports or overuse.

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OA Supportive Devices

Devices used to minimize potential side effects of OA Medication.

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Knee or elbow braces to stabilize

Knee or elbow stabilizers during exercise

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Non-Pharmacological

To avoid or minimize meds with potential side effects

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Pharmacological

NSAID's, Corticosteroids in OA

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Lab/Diagnostic Tests

X-Ray, MRI, Joint space narrowing

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Geriatric Considerations

Older patients are more likely to have this condition.

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OA Pathophysiology

Progressive destruction of joint cartilage and subchondral bone, with osteophytes and sclerosis.

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OA - Inflammation?

A localized, noninflammatory, progressive joint disease.

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OA - Common Joints

Hands, knees, feet, and hips are the most commonly affected.

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OA - Joint Involvement

Can affect one joint, a few joints, or many joints throughout the body.

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OA - Main Symptom

Pain is the primary symptom that leads patients to seek medical care.

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OA: Subchondral sclerosis

Hardening of bone beneath the cartilage.

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