Osteoarthritis (OA): NEET PG High-Yield
Degenerative Joint Disease (DJD)
1. Pathology & Clinical Features
OA is fundamentally a disease of articular cartilage. It is characterized by degradation of cartilage, subchondral bone sclerosis, and osteophyte formation.
- Symptoms: Mechanical pain (worsens with activity, improves with rest), morning stiffness < 30 minutes.
- Hand Involvement:
- Heberden’s nodes: DIP joints (most common).
- Bouchard’s nodes: PIP joints.
- 1st CMC joint: Characteristic involvement in thumb OA.
2. NEET PG High-Yield Pearls
| Imaging Finding | High-Yield Detail |
|---|---|
| X-ray Signs | Joint space narrowing (asymmetric), subchondral sclerosis, osteophytes, and subchondral cysts. |
| Kellgren-Lawrence | The standard classification system used to grade the severity of OA on X-ray (Grade 0–4). |
3. Management
- Conservative: Weight loss (if knee/hip), physiotherapy, quadriceps strengthening, and NSAIDs.
- Surgical: Osteotomy (young patients with unicompartmental disease); Total Joint Arthroplasty (end-stage disease).
- Primary vs. Secondary: Primary is age-related (“wear and tear”). Secondary is due to underlying trauma, obesity, or metabolic disease (e.g., Hemochromatosis).