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All info on OA, including Sx, Ix, Dx, Mx
Background
Not an inflammatory condition |
Occurs in synovial joints |
Due to genetic factors, overuse, and injury |
Presentation
Joint pain |
Stiffness for <30mins - worse with activity |
Crepitus |
Limited range of movement |
Commonly Affected Joints
Hips |
Knees |
SI joints |
DIPs + MCP |
Wrist |
Cervical spine |
Complications of THR
Neurovascular injury (external iliac) |
Infection |
Dislocation |
Periprosthetic fracture |
Loosening of implant + polyethylene wear, implant failure |
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Risk Factors
Obesity |
Age |
Occupation |
Trauma |
Female |
Family history |
Hand Signs
Heberden's nodes (DIP)
Bouchard's nodes (PIP)
Squaring of thumb (CMC)
Weak grip
Reduced range of motion
Difference Between OA and RA
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Diagnosis
No investigations needed if: |
Patient over 45 |
Has typical activity-related pain |
No morning stiffness |
Stiffness lasts <30 mins |
Management
1st line |
Patient education, physio, OT, orthotics |
2nd line |
Analgesia
PO paracetamol + topical NSAIDs
Add PO NSAIDs (+ PPI)
Opiates (codeine, morphine) |
3rd line |
Intra-articular steroid injections |
4th line |
Joint replacement |
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