Osteoarthritis
Which are the main joints affected by OA?
Weight-bearing joints (hips, knees, cervical and lumbar spine).
Overused joints (1st CMCJ, 1st TMTJ).
Distal IPJs > Proximal IPJs.
Which part of the spine is most affected by disc degeneration?
(Hint: The most weight-bearing part of the spine)
Lumbar spine.
What is a meniscus?
A fibrocartilage disc within a joint cavity.
What typically causes tendinopathy?
Repeated compression/trauma of a tendon.
E.g. Supraspinatus tendon is at risk of compression over the greater tuberosity of the humerus during shoulder adduction.
Who is Taylor Swift's boyfriend?
Travis Kelce
What is one of the main management principles of OA?
Any 1 of the following:
- Appropriate exercise (strengthening, aerobic fitness).
- Education.
- Weight management.
Paracetamol and NSAIDs should be 2nd line treatment.
What is a risk factor for vertebral disc degeneration?
Any 1 of the following:
- Genetics.
- Smoking.
- High and repetitive mechanical loading.
- Trauma.
- Ageing.
- Nutrition.
- Infections.
What is the function of a meniscus?
Any 1 of the following:
- Partially subdivides the synovial cavity to increase mobility.
- Resist compressive forces.
- Stabilise the joint.
What is the difference between tendon pathology and tendinopathy?
Tendon Pathology: A problem with the tendon, but can be asymptomatic.
Tendinopathy: Pain and loss of function associated with tendon pathology.
How many albums does Taylor Swift have?
11
(Extra points for every album you can name).
What is primary vs. secondary OA?
Primary: Idiopathic, linked to ageing.
Secondary: Occurs due to a predisposing condition (e.g. injury, congenital abnormality), occurs in younger patients.
What happens to the water and proteoglycan content of the nucleus pulposus in disc degeneration?
Decreases
What is the difference between an acute vs. a degenerative meniscus tear?
Acute: From excessive force.
Degenerative: From repetitive normal forces wearing down the meniscus.
What does inappropriate repair of a tendon lead to?
Calcification of the tendon.
What is Taylor Swift's middle name?
Alison
What are two key differences between OA and RA?
Any 2 of the following:
- Pathogenesis: Mechanical/degenerative (OA) vs. autommune (RA).
- Inflammation: Secondary (OA) vs. primary (RA).
- Joints Involved: Large weight-bearing joints (OA) vs. small joints (RA).
- Serum Antibodies: Not present (OA) vs. present (ACPA/RF) (RA).
What is one of the conservative management principles for degenerative meniscus tears?
Any 1 of the following:
- Exercise therapy.
- Analgesia/NSAIDs.
What is Taylor Swift's lucky number?
(Hint: It's her birthday).
13
What is the pathogenesis of OA?
- Cartilage damage due to mechanical stress on the joints.
- Chondrocytes proliferate and produce excess collagenases and metalloproteinases, causing articular cartilage degeneration.
- Inflammation, remodelling of underlying subchondral bone, formation of subchondral cysts and joint space narrowing.
Acute meniscus tear, locked knee (fixed flexion).