 What comes in our Sink School Explained in this video on osteoarthritis? Now osteoarthritis is very different from rheumatoid arthritis, so please make sure you also check out the other video so you know how to distinguish the two. In terms of pathophysiology, for osteoarthritis there is damage to the joint cartilage because of either major trauma, so some real bad injury that happened to that joint or some repetitive minor trauma or minor injuries, micro trauma that just persists over time. And so what happens, these osteophytes form, they're also called bone spurs, and they try to repair the damage caused by that trauma to that joint capsule, joint cartilage. And then these osteophytes are basically new cartilage and bone that try to repair the damage that has occurred, and that then causes pain and decreased range of motion. So if we look at this here, here's a healthy joint. So we have the two bones here, the cartilage kind of is at the end of the bone to kind of cover that, and in here in red, and then the joint capsule surrounds the entire joint, and in between we have synovial fluid to kind of act as a buffer. In osteoarthritis the joint space here is narrowed, you can see the two bones being closer together, that cartilage that we talked about over here is thinned because of this repetitive trauma, and then these osteophytes or bone spurs they form on the side, and then as the joint moves there is not that much cartilage left, plus we're losing that synovial fluid that acts as the buffer, and then in addition we have these bone spurs, these like out gross now of new bone that are kind of jagged, that rub on the opposing bone or on the joint capsule somewhere. And so risk factors for osteoarthritis, it occurs more often in postmenopausal women, and then also in patients who are obese because you can really think about that the extra weight that a patient is carrying can contribute to this micro trauma that we talked about here, putting extra pressure and extra stress on that joint and then eventually that joint cartilage was wearing down. So signs and symptoms here with the thin cartilage and the decreased joint space, we have decreased range of motion, the joint might be tender to paupatium, there might be some swelling and or deformities because of these osteophytes, these bone spurs, and the patient many times complains of morning stiffness that lasts less than 30 minutes, and that is a distinguishing factor here between rheumatoid arthritis because that typically lasts more than 30 minutes, and that's a question that sometimes comes up on n-clicks or course exams. And then sometimes there can be some crepitus of the joint, so that is when the joint is moved, it's kind of noisy, you can kind of hear that cartilage rubbing against each other or those bone spurs kind of rubbing against the bone, the acro bone that was there. And then many times the patient has increased pain with activity and weather changes. So this is when somebody says, oh, I think the weather is going to change, my joints are starting to be achy. And then the pain typically decreases with rest, symptoms occur asymmetrically, so it can be the right finger and the left toe, where in rheumatoid arthritis they're typically symmetrical, so the same joints are affected on each side, but here asymmetrical. And then common joints affected are the thumbs and the fingers, the hips and the knees, and then the cervical as well as the lumbar spine. And then we have certain nodes that we can see and these apply to the fingers of the hands. And number one are the he burdens nodes and then the bouchards nodes. And that depends on whether these nodes, these osteophytes are visible on the distal, the distal interphalangeal joint, which is the last joint or the proximal interphalangeal joint. So the distal ones here are the he burdens and the bouchards are the more proximal nodes here that you see. And that's something that also comes up in comparison to rheumatoid arthritis on those pesky exams. As for diagnostic tests, they're typically diagnosis is made based on the patient's symptoms with everything we just talked about. Sometimes an x-ray is ordered and that can show that joint space narrowing and these bone spurs, these outgrows. Sometimes CT or MRI can be helpful, synovial fluid aspiration. And that is mostly to rule out rheumatoid arthritis because that is more of an inflammatory disorder and that synovial fluid would show that. And then also we can do certain blood tests, CRP, ESR, rheumatoid factor and ANA, which are mostly all inflammatory markers. And that's also done because that's to rule out rheumatoid arthritis because sometimes we don't know which one it is. And these blood tests will help us determine that. And rheumatoid arthritis is more of a systemic chronic inflammatory disorder where these markers would be elevated where in osteoarthritis they are usually normal. And then treatment for osteoarthritis, so hydro cold, whatever feels better on the affected joint. Healthy nutrition is always important and then weight management to reduce the stress on these joints, particularly of the lumbar spine, the hips and the knees. And then active or passive range of motion and exercise to keep the joints moving and make sure that they don't become extra stiff. Collaboration of course with physical therapy and occupational therapy and then sometimes alternative measures can be helpful such as massage and acupuncture. Medications used for osteoarthritis are analgesics and that is typically insets or analgesics like Tylenol. Keep in mind that insets have the GI side effects and this is something that doesn't really go away so the patient would have to be on that chronically so we have to educate them about possible GI side effects and then to get their kidney function checked every so often to make sure that there's no no bad side effects on the kidneys. And then sometimes intraarticular steroids, so steroid injections directly into that joint can help reduce any inflammation there but that's usually temporary. If all that fails surgery can be recommended so arthroscopy to kind of get in there clean out and debride the joint and if it's really severe joint replacement can be helpful. As for nursing care we need to educate our patients about all these things we discussed here mostly about medications and possible side effects then promote activity and rest because we know that activity can be beneficial but it can also exacerbate symptoms so a healthy balance here of activity and rest is important and then home health can also be valuable in collaborating with PT and OT and then put the patient on this home exercise program to make sure that they stay mobile as long as they can. Thanks for watching this video on osteoarthritis. Please also check out the rheumatoid arthritis video so you can see the similarities and differences. I appreciate a thumbs up and see you soon right back here on nursing school explain. Thanks for watching.