read this it's a so simple and keep in health

1. Osteoarthritis
Items:
.Definition.
.Classification.
.Risk factors.
.Path physiology.
.Symptoms and signs.
.Diagnosis.
.Treatment.

2. Definition:
Osteoarthritis (OA), which is also known as
osteoarthrosis or degenerative joint disease
(DJD):
is a progressive disorder of the joints caused by
gradual loss of cartilage and resulting in the
development of bony spurs and cysts at the
margins of the joints.
Classification:
1.primary: unkown cause, with aging, on normal
joint.
2.secondary: other disease(trauma,
hemochromatosis, D.M, RA, congenital), any
age, on diseased joint.

3. Risk Factors
Age
Female
Obesity
malalignment
Repetitive knee bending
High impact activities
Muscle weakness
Other diseases : RA

4. Path physiology
OA is primarily disease of
cartilage.
Il-1 is a potent pro-
inflammatory cytokine,
which capable of inducing
chondrocytes and synovial
cells to synthesize MMPs.
MMPs is responsible of
degradation of articular
cartilage.
In addition, IL-1 inhibits
synthesis of collagen II,
proteoglycans and growth
factor B stimulated
chondrocyte proliferation

10. Symptoms and signs:
Pain increases with
activity and worse at
night.
Stiffness less than 30
mins.
Swelling
Deformities
Joint instability
Loss of function
Neurological signs if spine
Involved.
Crepitus
Muscle wasting

11. Diagnosis
No special test for diagnosis.
Clinically: History and Examination.
Lab investigations.

12. History
Age - > 50 years
BMI?
Occupation – what type?
Any history of trauma around the
joint?
Secondary causes –
congenital, RA
Any joint pain become worst by
activity, relieved by rest.
Joint stiffness – early
morning, long rest
Swelling?
Affect on daily activity !!
Climbing stairs

13. Examination
Movement
General examination
Crepitus
Inspection
Gait (antalgic!) Reduced/limited ROM
Deformity(varus/valgus)
Muscle wasting (quadricep)
Joint swelling
erythema
Palpation
Joint effusion
Tenderness
Palpable
osteophytes

14. Investigation:
1. Arthrocentsesis:
Synovial fluid
WBC<1000/mm3
Clear color
High Viscosity
2. X-ray:

16. Treatment:
1. Non-pharmacological:
To increase movement to prevent muscle
wasting and deformity/contracture.
physiotherapy/exercise programme,
non -weight bearing exercise to
strengthen muscle strength
(cycling, swimming etc).
To reduce load on the joint
Weight loss if patient is obese
Use of walking stick to distribute the
load
Avoid unnecessary stress,eg
jogging,climbing stairs.

17. 2. pharmacological: Group of Examples
drug
Pain relief
Analgesics Acetaminophen and
Analgesic and NSAIDS
tramadol
Intra-articular corticosteroid.
NSAID Aspirin, ibuprofen and
3. surgery. naproxen
Cox-2 celecoxib
inhibitors
Topical Cream or spray as zostrix
analgesics
Corticosteroid Injectable glucocorticoid
viscosupplem Hyaluronic acid
ents
Bone Glucosamine and
components Chondrotin Sulfate
Future degradative Enz Growth
therapy

18. Management:
Lifestyle Modifications Acetaminophen PRN
NSAIDs PRN Celecoxib
Steroid Injections Opioids PRN
Hyaluronan Injections
Surgical Referral

19. Surgery:
Arthroscopy
Mainly for knee and shoulder.
Remove of loose pieces of bone or cartilage and
treatment of torn ligament or inflamed synovial
membrane
Osteotomy
Mainly for knee and hip.
For people younger to do joint replacement.
Repositioning of bone by a wedge shape cut.
Joint Replacement
For people over 50y or severe progression
Reconstruction of a joint