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Difference between revisions of "Osteoarthritis"
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| IF = | | IF = | ||
| Gross = thinning/loss of cartilage, osteophyte formation, subchondral cysts, subchondral sclerosis | | Gross = thinning/loss of cartilage, osteophyte formation, subchondral cysts, subchondral sclerosis | ||
| Grossing = | | Grossing = [[femoral head grossing]], [[knee replacement specimen grossing]] | ||
| Site = [[joints]], e.g. [[femoral head]], knee, shoulder | | Site = [[joints]], e.g. [[femoral head]], knee, shoulder | ||
| Assdx = trauma to joint, [[obesity]] (for knees), congenital disease ([[SCFE]], [[Legg–Calvé–Perthes disease]]), complication of [[avascular necrosis of the femoral head]] | | Assdx = trauma to joint, [[obesity]] (for knees), congenital disease ([[SCFE]], [[Legg–Calvé–Perthes disease]]), complication of [[avascular necrosis of the femoral head]] | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = old | | Clinicalhx = often old, +/-history of trauma | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = joint pain worse with activity, "morning stiffness" | ||
| Prevalence = very common | | Prevalence = very common | ||
| Bloodwork = | | Bloodwork = | ||
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==General== | ==General== | ||
Clinical: | |||
*Morning stiffness (<30 minutes).<ref name=pmid24881169>{{Cite journal | last1 = Negoescu | first1 = A. | last2 = Ostör | first2 = AJ. | title = Self-management pivotal in osteoarthritis. | journal = Practitioner | volume = 258 | issue = 1770 | pages = 25-8, 3 | month = Apr | year = 2014 | doi = | PMID = 24881169 }}</ref> | |||
*Worse with exercise.<ref>URL: [http://www.nlm.nih.gov/medlineplus/ency/article/000423.htm http://www.nlm.nih.gov/medlineplus/ency/article/000423.htm]. Accessed on: October 25, 2014.</ref> | |||
Management: | |||
*Acetaminophen (paracetamol). | |||
*Other analgesics. | |||
*Joint replacement. | |||
===Risks=== | ===Risks=== | ||
It is associated with:<ref name=pmid20302555>{{Cite journal | last1 = Martel-Pelletier | first1 = J. | last2 = Pelletier | first2 = JP. | title = Is osteoarthritis a disease involving only cartilage or other articular tissues? | journal = Eklem Hastalik Cerrahisi | volume = 21 | issue = 1 | pages = 2-14 | month = Apr | year = 2010 | doi = | PMID = 20302555 | url=http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--www.tevak.org-images-Eklemlinkout.png }} | It is associated with:<ref name=pmid20302555>{{Cite journal | last1 = Martel-Pelletier | first1 = J. | last2 = Pelletier | first2 = JP. | title = Is osteoarthritis a disease involving only cartilage or other articular tissues? | journal = Eklem Hastalik Cerrahisi | volume = 21 | issue = 1 | pages = 2-14 | month = Apr | year = 2010 | doi = | PMID = 20302555 | url=http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--www.tevak.org-images-Eklemlinkout.png }} | ||
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*Advanced age. | *Advanced age. | ||
*Trauma. | *Trauma. | ||
*Unusual loading (bony misalignment, [[obesity]]). | *Unusual loading (bony misalignment, [[obesity]]). | ||
==Gross pathology/radiology== | ==Gross pathology/radiology== | ||
| Line 45: | Line 54: | ||
#Loss of cartilage, especially asymmetrical. | #Loss of cartilage, especially asymmetrical. | ||
#*Marble-like appearance - polished appearance known as ''eburnation''. | #*Marble-like appearance - polished appearance known as ''eburnation''. | ||
#Osteophyte formation. | #[[Osteophyte]] formation. | ||
#Subchondral cysts - located where there is loss of cartilage.<ref name=pmid404905>{{Cite journal | last1 = Resnick | first1 = D. | last2 = Niwayama | first2 = G. | last3 = Coutts | first3 = RD. | title = Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint. | journal = AJR Am J Roentgenol | volume = 128 | issue = 5 | pages = 799-806 | month = May | year = 1977 | doi = | PMID = 404905 }}</ref> | #Subchondral cysts - located where there is loss of cartilage.<ref name=pmid404905>{{Cite journal | last1 = Resnick | first1 = D. | last2 = Niwayama | first2 = G. | last3 = Coutts | first3 = RD. | title = Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint. | journal = AJR Am J Roentgenol | volume = 128 | issue = 5 | pages = 799-806 | month = May | year = 1977 | doi = | PMID = 404905 }}</ref> | ||
#Subchondral sclerosis. | #Subchondral sclerosis. | ||
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**[[Avascular necrosis of the femoral head]]. | **[[Avascular necrosis of the femoral head]]. | ||
**Trauma. | **Trauma. | ||
**Slipped capital femoral epiphysis (SCFE).<ref>{{Cite journal | last1 = Abraham | first1 = E. | last2 = Gonzalez | first2 = MH. | last3 = Pratap | first3 = S. | last4 = Amirouche | first4 = F. | last5 = Atluri | first5 = P. | last6 = Simon | first6 = P. | title = Clinical implications of anatomical wear characteristics in slipped capital femoral epiphysis and primary osteoarthritis. | journal = J Pediatr Orthop | volume = 27 | issue = 7 | pages = 788-95 | month = | year = | doi = 10.1097/BPO.0b013e3181558c94 | PMID = 17878786 }}</ref> | **[[Slipped capital femoral epiphysis]] (SCFE).<ref>{{Cite journal | last1 = Abraham | first1 = E. | last2 = Gonzalez | first2 = MH. | last3 = Pratap | first3 = S. | last4 = Amirouche | first4 = F. | last5 = Atluri | first5 = P. | last6 = Simon | first6 = P. | title = Clinical implications of anatomical wear characteristics in slipped capital femoral epiphysis and primary osteoarthritis. | journal = J Pediatr Orthop | volume = 27 | issue = 7 | pages = 788-95 | month = | year = | doi = 10.1097/BPO.0b013e3181558c94 | PMID = 17878786 }}</ref> | ||
===Grading=== | ===Grading=== | ||
| Line 116: | Line 125: | ||
===Images=== | ===Images=== | ||
<gallery> | |||
Image: Degenerative joint disease - severe -- very low mag.jpg | Severe DJD - very low mag. | |||
Image: Degenerative joint disease - severe - alt -- very low mag.jpg | Severe DJD - very low mag. | |||
Image: Degenerative joint disease - severe -- low mag.jpg | Severe DJD - low mag. | |||
Image: Degenerative joint disease - severe - alt -- low mag.jpg | Severe DJD - low mag. | |||
Image: Degenerative joint disease - severe -- intermed mag.jpg | Severe DJD - intermed. mag. | |||
</gallery> | |||
<gallery> | |||
Image: Degenerative joint disease -- very low mag.jpg | Moderate DJD - very low mag. | |||
Image: Degenerative joint disease -- low mag.jpg | Moderate DJD - low mag. | |||
Image: Degenerative joint disease - alt -- low mag.jpg | Moderate DJD - low mag. | |||
Image: Degenerative joint disease -- intermed mag.jpg | Moderate DJD - intermed. mag. | |||
Image: Degenerative joint disease - alt -- intermed mag.jpg | Moderate DJD - intermed. mag. | |||
</gallery> | |||
www: | |||
*[http://ars.els-cdn.com/content/image/1-s2.0-S8756328212000683-gr1.jpg Osteoarthritis showing villous hyperplasia - panel B (els-cdn.com)]. | *[http://ars.els-cdn.com/content/image/1-s2.0-S8756328212000683-gr1.jpg Osteoarthritis showing villous hyperplasia - panel B (els-cdn.com)]. | ||
*[http://www.medpath.info/MainContent/Skeletal/3097.GIF Osteophyte (medpath.info)].<ref>URL: [http://www.medpath.info/MainContent/Skeletal/Joint_02.html http://www.medpath.info/MainContent/Skeletal/Joint_02.html]. Accessed on: 10 November 2012.</ref> | *[http://www.medpath.info/MainContent/Skeletal/3097.GIF Osteophyte (medpath.info)].<ref>URL: [http://www.medpath.info/MainContent/Skeletal/Joint_02.html http://www.medpath.info/MainContent/Skeletal/Joint_02.html]. Accessed on: 10 November 2012.</ref> | ||