Osteoarthritis clinical features and examination.pptx

Osteoarthritis clinical features and examination findings mbbs orthopedics medical school

1. Clinical features The disease occurs in elderly people, mostly in the major joints of the lower limb , frequently bilaterally.

2. Pain: Activity & weight- bearing related , relieved by rest Variable over time Only one or few joints involved Later it becomes worse and cramp-like, and comes after activity. Morning stiffness - brief - <30 minutes A coarse crepitus may be complained of by some patients

3. Swelling of the joint - is usually a late feature, and is due to the effusion caused by inflammation of the synovial tissues. Stiffness - initially due to pain and muscle spasm later, capsular contracture and incongruity of the joint surface contribute to it Restricted functionality- Capsular thickening -Blocking by osteophytes

4. Clinical findings in Generalised OA Pain and stiffness Swelling of one or few finger phalanges (distal >proximal) Heberden’s nodes ( +/- Bouchard’s nodes) Involvement of first carpometacarpel joint

5. Clinical findings in Knee Targets - patello-femoral & medial tibio-femoral compartment of knee Pain is localized to anterior or medial aspect of knee and upper tibia Jerky gait Varus deformity

6. Joint line & periarticular tenderness Weakening & wasting of quadriceps muscles Restricted extension and flexion Bony swelling around joint

7. Clinical findings in Hip Targets - Mostly superior aspects & less commonly medial aspect of joint Pain is maximally deep in groin area Antalgic gait Weakness & wasting of muscles ( quadriceps & gluteal ) Pain & restricted internal rotation with flexion

8. Examination Tenderness on the joint line Crepitus on moving the joint Irregular and enlarged-looking joint due to formation o f peripheral osteophytes Deformity –varus of the knee,flexion -adduction-external rotation of the hip

9. Examination Effusion – rare and transient terminal limitation of joint movement Subluxation detected on ligament testing Wasting of quadriceps femoris muscle