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Osteoarthritis Concept Map: An Overview
Definition
The map starts with osteoarthritis (OA) definition which states that OA is a degenerative non-inflammatory joint
disease that is characterized by:
- Progressive damage to the articular cartilage
- Thickening of subchondral bone & joint capsule
- Formation of osteophytes
- Mild synovitis
Classification
Osteoarthritis is classified into:
A-
Idiopathic (primary) OA; there is no known underlying or predisposing
cause.
B- Secondary OA; which is associated with predisposing factors as: trauma,
repetitive stress (occupation, sports), congenital abnormality, metabolic
disorder, endocrine disorder (DM, obesity), or other bone/joint disease
(Rheumatoid Arthritis, gout).
Epidemiology
· Prevalence
- most common joint disease
- most common form of arthritis
- most common reason for total hip & total-knee replacement
- causes high morbidity and financial loss due to the important joints involved
- knee OA is a leading cause of chronic disability in elderly
- >90 % of persons > 40 yo have some radiographic changes of OA in weight-bearing
- joints, but only 30% are symptomatic
· Predominant age:
>50 yr· Sex
- Hip OA: men > women
- OA of interphalangeal joints, thumb base, and knee is more common in women
· Race:
There are differences in prevalence and pattern of involved joints.Risk Factors
The most powerful risk factor for
osteoarthritis is age.
The most common risk factors are:
- obesity (in women, there is a linear relationship between weight and risk),
- previous occupation,
- certain sports,
- previous joint trauma
- genetic predisposition
- female gender
- congenital/developmental defects
- prior inflammatory joint disease
- metabolic/endocrine disorders
Osteoarthritis develops when systemic factors
combine with biomechanical susceptibilities. Systemic factors includes: age, gender, genetic predisposition, and
nutritional status.
Pathophysiology
In order to understand
osteoarthritis pathophysiology, you have to understand first its normal
physiology. Thus, the map provides a brief explanation of osteoarthritis normal
physiology, including articular cartilage functions, structure and composition.
After that, the map presents osteoarthritis
pathophysiology through the following diagram:
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| Osteoarthritis Pathophysiology - Click to enlarge |
Clinical Presentation & Diagnosis
General signs and symptoms
- Presentations from asymptomatic to severe joint pain, stiffness with
functional limitations
- Asymmetric joint involvement
- No systemic manifestations
Joint pain
- may affect ≥ 1 joint
- deep ache
- worsened by use and relieved by rest
- persists during rest (in advanced cases)
- nocturnal pain interfering with sleep (in advanced hip OA)
Joint stiffness
- after periods of inactivity (e.g., sleep or automobile ride)
- lasts < 20 minutes
- impairs daily activities
- may be related to weather
• Mild synovitis (in advanced
cases)
• Joint instability in
weight-bearing joints
• Joint/bony crepitus (the
sensation of bone rubbing against bone, evoked by joint movement)
Common sites in primary and
secondary osteoarthritis are shown in images included in the map.
Joint examination may reveal:
• local tenderness, bony proliferation, soft tissue swelling,
• muscle atrophy, limited motion, and effusion
Laboratory Tests
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No specific laboratory test
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Aspirated synovial fluid (if obtained): leukocytosis and high viscosity.
Other Diagnostic Tests
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Radiologic evidence may be misleading
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Radiographic changes may include:
are often absent in early osteoarthritis
joint-space narrowing, subchondral bone sclerosis, and osteophytes (with disease progression)
gross deformity and effusions (late osteoarthritis)
are often absent in early osteoarthritis
joint-space narrowing, subchondral bone sclerosis, and osteophytes (with disease progression)
gross deformity and effusions (late osteoarthritis)
Osteoarthritis Treatment
The map details pharmacological
treatment and offers brief information about non-pharmacological treatment and
surgical interventions. A treatment algorithm for osteoarthritis is also
included.
Medications used for the treatment
of osteoarthritis are represented in the form of comparison table.
The table includes:
• Analgesics: Acetaminophen
and Non-steroidal Anti-inflammatory Drugs (NSAIDs).
• Glucosamine and
Chondroitin.
• Intra-articular therapy: Corticosteroids
and Hyaluronic acid (Hyaluronan)
• Opioid analgesics
(Tramadol)
• Topical analgesics:
Topical NSAIDs Counterirritant.
The comparison includes
medications' mechanisms of actions, indications, dosages, adverse drug
reactions, drug interactions, precautions, and contraindications.
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| Osteoarthritis Medications Comparison |
Map's Format
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Delivery
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Printing
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Folded Poster
The maps is printed out on ordinary A1 size paper and it is folded to be nearly sized as A4 paper.
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Physical.
To be sent to your address through the Egyptian Registered Postal Mail.
Delivery in Egypt takes few days,
Other countries: 2-3 weeks; you can upgrade to express mail. Please contact us for details.
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Already printed out.
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Printable Version
The map is split into pages to be printed on six A4 papers. After printing them, you have to tape the edges together to make a folded poster.
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Electornic; Download link.
A .pdf file for the printable version of the map will be available for download immediately after payment received.
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Printing is allowed. The map is to be printed out on several pages.
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Version: 2.0
Last updated in: 1 July 2014
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