OA Exam

Question 1

Hx

Answer 1

• Familial history (esp. Heberden’s nodes)
• Age: Presents in middle age -> common in the elderly
• Secondary OA:
  
  • Hx of overuse;
  • injury / repeated injury;
  • joint surgery
  • obesity

Question 2

Jt Pain & Aggrevation

Answer 2

Joint Pain
* Asymptomatic in the early stages

• = Earliest symptom
• Insidious onset; increases over months-years
• May be local or referred

Aggravated by:
* use (during and after)

• cold or damp weather
• before or during a change in the weather
• periods of inactivity
• Joint symptoms better for:
• Rest (NB. Relief becomes less complete with time)

Question 3

Joint Involvement

Answer 3

• joint involvement is:
  
  • asymmetric
  • multiple
• mainly the weight bearing joints
• DIPs joints of fingers
  
  • toes also affected (and 1st MTP)

Question 4

Joint Stiffness

Answer 4

• common
• occurs after inactivity (gelling)
  
  • esp. morning stiffness
  • lasts < 30 min
• gradually becomes constant and aggressive
• improves with movement
• can cause slow difficult movement

Question 5

Claudication

Answer 5

• neuro claudication, yo!

Question 6

Joint Swelling, Warmth, Deformity

Answer 6

• Heberden’s nodes are typical
• Swelling can be:
  
  • intermittent (synovial effusion)
  • continuous (capsular thickening and osteophytes)
• Joint warmth (intermittent, d/t inflammation)
• Joint Deformity
  
  • > knee OA can cause “bow legs” (Genu varum) or “knock knees” (Genu valgum)

Question 7

SSx- General Articular

Answer 7

• Crepitus
  
  • (crunching, creaking , grating sound or sensation)
• Reduced ROM;
  
  • capsular pattern in affected joints
• Tenderness
  
  • Joint
  • Periarticular tissues
• Joint locking
  
  • Mechanical block by intra-articular loose bodies or menisci dislocation

Question 8

SSx- Neuro

Answer 8

• Neurological symptoms
  
  • myelopathy / radiculopathy (d/t impingement by osteophytes)
• radicular pain
• numbness and tingling