Osteoarthritis
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What is Arthritis?
Inflammation of the joints
What is Osteoarthritis?
Causes joints to become painful and stiff A clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life Disorder of the joints Articular cartilage loss Accompanying periarticular bone response Can affect any joint Weight bearing and non-weight bearing joints
What is the most common from of Arthritis?
Osteoarthritis
Describe the Epidemiology of Osteoarthritis in the population?
~8.75million people in the UK4 aged 45yr+ Prevalence increases with age More common in women than men5 Knee is most common site 18.2% of people aged over 45 years in England have Osteoarthritis of the KNEE. 10.9% of people aged over 45 years in England have Osteoarthritis of the HIP.
What are the Co-morbidities of Osteoarthritis and its effect on the QoL?
Co-morbidities Cardiovascular disease Depression Quality of Life Pain Work
Detail the pathological changes in Osteoarthritis?
Whole joint is involved Rate of damage exceeds rate of repair Joint fails to dissipate ‘load’ effectively Leads to cycle of degeneration Exposes bone to more load more damage Further loss of cartilage and growth of osteophytes Narrowing of joint space Results in synovitis and effusion
Describe the risk factors and causes of osteoarthritis?
Primary – idiopathic Secondary – specific cause i.e. previous injury to joint, congenital abnormality or inflammatory arthritis
What are the Risk factors of Osteoarthritis?
Risk factors: Age (45+) Gender (female) Obesity (BMI >25) Occupation (physically demanding) Genetics Estimated heritability of 40-65% depending on joint site
Describe how Osteoarthritis is diagnosed?
Signs/Symptoms: Activity related joint pain Morning stiffness lasts no longer than 30 minutes Muscle wasting Hand/fingers often presents as ‘nodes’ Diagnosed clinically without investigations Activity related joint pain AND Morning stiffness lasts no longer than 30 minutes (OR no morning stiffness) AND Over 45 years X-rays and blood tests may be help to aid diagnosis
Discuss the Pharmacological treatment options in Osteoarthritis?
Pharmacological treatments mostly involves pain relief: Topical NSAIDs or Topical capsaicin Paracetamol Oral NSAIDs (+PPI) Opioids Intra-articular corticosteroids Others… Surgery
Discuss the Non-Pharmacological treatment options in Osteoarthritis?
Holistic approach Lifestyle changes Weight loss Exercise: CORE Physical aids
What is the summary for Osteoarthritis in terms of patient care?
No pharmacological treatments to help prevent or cure Offer moderate symptomatic relief Lifestyle change is key in management Exercise should be part of daily routine Limited role medication can play must be explained to patient