Reference no: EM133718334

CASE STUDY

Introduction Recap:

Osteoarthritis (OA) is a degenerative joint disorder characterized by the gradual breakdown of joint cartilage and the underlying bone. Understanding the pathophysiology of OA involves examining deviations from the normal anatomy and physiology of joints.

Normal Joint Anatomy:

Articular Cartilage: Joints are covered with articular cartilage, a specialized connective tissue that provides a smooth, low-friction surface for joint movement. Articular cartilage is composed of chondrocytes embedded in a matrix of collagen and proteoglycans, imparting strength and flexibility to the joint.

Synovial Membrane: The synovial membrane lines the joint capsule and secretes synovial fluid, which lubricates and nourishes the articular cartilage. Synovial fluid contains nutrients and substances essential for cartilage health, including hyaluronic acid.

Joint Capsule and Ligaments: The joint capsule surrounds the joint, providing stability, and ligaments connect bones, limiting excessive joint movement.

Subchondral Bone: Beneath the articular cartilage lies the subchondral bone, providing structural support to the joint.

Scenario/Summary

Mrs. Johnson, a 62-year-old woman, presents to her primary care physician with complaints of persistent joint pain and stiffness, particularly in her knees and hands. She reports that the pain is worse in the morning and improves throughout the day with movement. Mrs. Johnson mentions that the symptoms have been gradually progressing over the past several years, impacting her ability to engage in activities she once enjoyed, such as walking and gardening.

Upon examination, the physician observes joint tenderness, swelling, and crepitus in Mrs. Johnson's knees and hands. There are no signs of significant joint warmth or redness. Her medical history reveals a long-standing history of overweight and a family history of osteoarthritis. X-rays of the affected joints show joint space narrowing, osteophyte (bone spur) formation, and subchondral sclerosis - characteristic features of osteoarthritis.

The physician discusses the diagnosis of osteoarthritis with Mrs. Johnson, explaining that it is a degenerative joint disease characterized by the breakdown of cartilage and changes to the underlying bone. The risk factors, including age, obesity, and family history, are discussed.

Discussion:

Osteoarthritis is characterized by the degeneration of the articular cartilage that lines the bony ends, where two bones touch; the resulting friction of bone against bone worsens the condition, associated with the elderly. Osteoarthritis most commonly affects weight-bearing joints and joints that undergo repetitive stress over a lifetime.

General Overview

· Prevalence: most common joint disorder

· Incidence: increases with age

· Sex: ? > ?

· Incidence rates in specific joints: knee > hip > hand

Deliverables

Please address the following questions in complete sentences.

1. Which joint allows the most mobility?

2. what is the functional and structural classification of the knee joint and the hip joint

3. list all the hand joints that osteoarthritis affects. Be sure to mention the structural classification of these hand joints.

4. Using only the clinical case as an example, list the risk factors discovered in this client that increased the likelihood of developing osteoarthritis.

5. What other joint disease must be ruled out to ensure accurate diagnoses of osteoarthritis?