Osteoarthritis

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Osteoarthritis

Pathology

Pediatric musculoskeletal conditions

Radial head subluxation (Nursemaid elbow)

Developmental dysplasia of the hip

Legg-Calve-Perthes disease

Slipped capital femoral epiphysis

Transient synovitis

Osgood-Schlatter disease (traction apophysitis)

Musculoskeletal injuries and trauma

Rotator cuff tear

Dislocated shoulder

Radial head subluxation (Nursemaid elbow)

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Iliotibial band syndrome

Unhappy triad

Anterior cruciate ligament injury

Patellar tendon rupture

Meniscus tear

Patellofemoral pain syndrome

Sprained ankle

Achilles tendon rupture

Spondylolysis

Spondylolisthesis

Degenerative disc disease

Spinal disc herniation

Sciatica

Compartment syndrome

Rhabdomyolysis

Bone disorders

Osteogenesis imperfecta

Craniosynostosis

Pectus excavatum

Arthrogryposis

Genu valgum

Genu varum

Pigeon toe

Flat feet

Club foot

Cleidocranial dysplasia

Achondroplasia

Osteomyelitis

Bone tumors

Osteochondroma

Chondrosarcoma

Osteoporosis

Osteomalacia and rickets

Osteopetrosis

Paget disease of bone

Osteosclerosis

Lordosis, kyphosis, and scoliosis

Joint disorders

Osteoarthritis

Spondylosis

Spinal stenosis

Rheumatoid arthritis

Juvenile idiopathic arthritis

Gout

Calcium pyrophosphate deposition disease (pseudogout)

Psoriatic arthritis

Ankylosing spondylitis

Reactive arthritis

Spondylitis

Septic arthritis

Bursitis

Baker cyst

Muscular disorders

Muscular dystrophy

Polymyositis

Dermatomyositis

Inclusion body myopathy

Polymyalgia rheumatica

Fibromyalgia

Rhabdomyosarcoma

Neuromuscular junction disorders

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Other autoimmune disorders

Sjogren syndrome

Systemic lupus erythematosus

Mixed connective tissue disease

Antiphospholipid syndrome

Raynaud phenomenon

Scleroderma

Limited systemic sclerosis (CREST syndrome)

Musculoskeletal system pathology review

Back pain: Pathology review

Rheumatoid arthritis and osteoarthritis: Pathology review

Seronegative and septic arthritis: Pathology review

Gout and pseudogout: Pathology review

Systemic lupus erythematosus (SLE): Pathology review

Scleroderma: Pathology review

Sjogren syndrome: Pathology review

Bone disorders: Pathology review

Bone tumors: Pathology review

Myalgias and myositis: Pathology review

Neuromuscular junction disorders: Pathology review

Muscular dystrophies and mitochondrial myopathies: Pathology review

Pediatric musculoskeletal disorders: Pathology review

Assessments

Osteoarthritis

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USMLE® Step 1 questions

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High Yield Notes

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Osteoarthritis

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Questions

USMLE® Step 1 style questions USMLE

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A 65-year-old man comes to his primary care provider for evaluation of pain in both knees. His symptoms worsen with activity and improve with rest and ibuprofen. The patient had previously been an avid runner but had to stop due to the joint pain. Past medical history is notable for hypertension and a right fibular fracture, which occurred after a biking accident. Vitals are within normal limits. Examination of the affected joints reveals crepitus and mildly reduced range of motion. The remainder of the patient’s physical examination is noncontributory. Knee imaging is ordered, and the results are as follows:




Reproduced from: Radiopedia

Which of the following additional findings, if present, would best support the patient’s diagnosis?

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Acetaminophen p. 498

for osteoarthritis p. 476

Chondrocytes

osteoarthritis p. 476

Nonsteroidal anti-inflammatory drugs (NSAIDs) p. 499

osteoarthritis p. 476

Obesity

osteoarthritis/rheumatoid arthritis p. 476

Osteoarthritis p. 476

celecoxib for p. 499

presentation p. 718

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Tanner Marshall, MS

Osteo- means “bone”, and -arth- refers to “arthron” which means joint, and -itis means “inflammation”, so osteoarthritis is a disease involving inflammation of the bone and joint cartilage.

It was once thought that the “itis” part of osteoarthritis was a misnomer, and that inflammation didn’t play a role in its development, and that it was mostly a degenerative disease resulting from simple “wear and tear”.

Nowadays, it’s thought that inflammation does indeed play an important role in the development of osteoarthritis.

Alright, so a healthy joint consists of two bones, each with its own layer of articular cartilage, which is a type of connective tissue that allows the two bones to glide against each other essentially without friction.

With Osteoarthritis, we’re really talking about one particular kind of joint which is a synovial joint.

Along with articular cartilage, another important component of synovial joints, and where they get their name from, is the synovium, which along with the surface of the articular cartilage, forms the inner lining of the joint space.

The synovium’s composed of loose connective tissue, blood vessels, lymphatic vessels, and on the surface—”Type A” cells that clear cellular debris and “Type B” cells that produce components of synovial fluid, which helps lubricate the two articular surfaces.

One of the main issues in osteoarthritis is the progressive loss of this articular cartilage, which means there’s not much separating the two bones anymore, which adds a significant amount of friction between them, which then generates inflammation, and triggers pain through the nerve endings in this joint space.

Maintaining healthy articular cartilage is the chondrocyte’s job, a specialized cell responsible for maintaining everything cartilage-related.

Summary

Osteoarthritis is a degenerative joint disease usually caused by age-related breakdown of joint cartilage and underlying bone. This leads to stiffness and pain in weight-bearing joints that worsens with activity and improves with rest. Other symptoms of osteoarthritis include a grinding sensation when the joint is moved, and difficulty moving the affected joint. Risk factors for developing osteoarthritis include advancing age, obesity, and joint injury. Treatment involves losing weight, moderate exercise, physical therapy, and drugs to reduce pain and inflammation.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Osteoarthritis" The Lancet (2015)
  6. "OARSI guidelines for the non-surgical management of knee osteoarthritis" Osteoarthritis and Cartilage (2014)
  7. "The Mechanobiology of Articular Cartilage: Bearing the Burden of Osteoarthritis" Current Rheumatology Reports (2014)
Elsevier

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