CASE PRESENTATION
Osteoarthritis
Moderator.
Dr Varun
Presenter
Vaishnavi
Intern MBBS 2018-19 batch
Reg no-18M01192
Patient aged 64 yrs was apparently normal 2 yrs ago when she developed pain in right knee which
was insidious in onset gradually progressive,crampy type, non radiating, aggravated by walking
and climbing stairs and relieved by taking rest. However the pain increased in the past 2 months.
This pain is associated with limited range of movement of knee
She also have similar complaint in her left knee but is milder compared to her left knee.
No history of morning stiffness
No history of trauma or fall, no fever
Not a k/c/o diabetes ,hypertension ,asthma, Tb
CLINICAL EXAMINATION
64 yrs old female patient is moderately built and nourished,conscious , cooperative alert and well oriented to time ,place and
person
No pallor ,icterus,clubbing,cyanosis,lymphadenopathy and edema
VITALS: BP: 130/76 mmHg
Pulse: 84bpm
SpO2: 99%
Resp rate : 16cpm
Temperature - Afebrile
Local Examination
Patient is in supine position, ASIS and patella at same level
Gait
: Antalgic gait
Inspection: swelling of right knee present
Muscle wasting at left thigh and left calf
No deformity
No scars ,sinuses
Palpation: no local rise of temperature
Tenderness present
Crepitus on moving joint
Movements: range of movements were painful and restricted
Radiological findings
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Asymmetric distribution
Joint space narrowing (medial> lateral)
Osteophytes - regeneration of bone, break off to form loose bodies
Subchondral sclerosis
Subchondral cysts
Intra articular loose bodies
Articular deformity -genu varus most common
Diagnosis
Osteoarthritis of right knee
Osteoarthritis
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Degenerative joint disease
Chronic non-inflammatory condition
Wear and tear of joints
Pain and disability in older people
Treatment
● LIFESTYLE CHANGES- REDUCING WEIGHT , QUADRICEPS STRENGTHENING
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EXERCISES, SHOCK ABSORBING FOOTWEAR
NON PHARMACOLOGICAL THERAPY-TENS,OR APPLICATION OF HEAT AND
COLD
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Pharmacological therapy-topical or oral NSAIDS ,GABAPENTIN
Intra articular glucocorticoid injection- for symptomatic reliefs
Chondrotin sulphate and glucosamine sulphate - neutraceuticals
Total Joint replacement surgery
THANK YOU