Untitled Quiz

Osteoarthritis (OA)

• OA is a chronic joint disease resulting in joint destruction and immobility.
• The protective cartilage that cushions the ends of bones progressively wears down.
• Common alternate names include "osteoarthrosis" and "degenerative joint disease."

Types of Osteoarthritis

• Primary (idiopathic): Most common form with no evident predisposing factor.
• Secondary: Similar pathologically to primary but linked to a known cause.

Epidemiology of OA

• Most prevalent type of joint disease globally.
• Joint distribution varies by gender; hip OA is more common in males, while OA in hands and knees is more common in females.
• Patterns of affected joints also differ based on race.

Risk Factors for OA

• Age is the most significant risk factor for OA development.
• Gender shows a predisposition; females are generally more affected.
• Other risk factors include previous joint injuries, obesity, and metabolic conditions.

Joints Frequently Affected by OA

• Typically affects hands, knees, hips, spine (cervical and lumbar), and major toe joints.
• Presents in a non-symmetric manner across joints.

Healthy Joint vs. OA Joint

• In healthy joints, smooth cartilage protects bone ends.
• In OA, cartilage wears away, leading to bone spurs, increased synovial fluid, stiffness, and pain.

Pathogenesis of OA

• Begins with damage to joint surfaces and thickening of surrounding bone.
• Characterized by progressive loss of articular cartilage impacting other tissues including subchondral bone and ligaments.
• Early changes include thicker cartilage, progressing to fibrillation and hypocellularity in late stages.

Signs and Symptoms of OA

• Deep, localized pain, aggravated by joint use but relieved with rest.
• Stiffness experienced particularly after inactivity, usually lasting 30 minutes or less.

Gout

• Gout is a chronic disease defined by elevated uric acid levels, causing painful mono- or oligoarticular inflammation.
• Risk factors include age, sex, family history, obesity, and specific dietary choices.
• Diagnosis confirmed via uric acid crystals in joints and clinical symptoms.

Diagnostic Tests for Gout

• Serum uric acid levels and 24-hour urine uric acid assessments are standard.
• Synovial fluid tests are employed to detect uric acid crystals.
• Radiographic findings aren’t specific for gout, RA, or OA.

Treatment Goals for Gout

• Focuses on pain control and inflammation reduction.
• Involves pharmacological strategies including NSAIDs and glucocorticoids, along with hyperuricemic therapy to manage uric acid levels.

Differences between Rheumatoid Arthritis (RA) and OA

• RA typically presents in younger patients (3rd to 5th decade), whereas OA mainly affects those over 45.
• RA symptoms include morning stiffness and systemic features, while OA features deep aches aggravated by use.
• Key distinguishing factors include joint distribution, radiographic findings, and laboratory results, with RA exhibiting abnormal ESR and RF positivity while OA typically shows normal ESR and RF negativity.