Step 7

1. how anatomy and physiology histology of joints?

2. why the swelling and pain in the knee just simply happen?

3. whether the definition of osteoartitris and kind?

OA is a disease desgeneratif chronic joint failures and attacks the joints, especially the joint cartilage.

Predilection affected joints are weight-bearing-joint: sendni neck, lumbosacral spine, knee, ankle,
falangeal first metatarsal joints, and joints CMC hand, PIP, AND DIP.

OA including health problems with morbidity and disbilitas high, particularly in elderly patients.

Kind:

o Primary Osteoarthritis mostly linked to aging. With aging, the water content of the cartilage increases,
and protein composition of cartilage degeneration.

o Secondary Osteoarthritis is caused by diseases or other conditions. Conditions that can lead to
secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal
joints at birth (congenital abnormalities)

Source: SELEKTA capita FKUI

4. why joints feel stiff and sore when in the morning and when sitting for too long?

5. The risk factors and symptoms of the case in the scenario?

intrinsic factor

Age (rare at age <40 years, often at the age> 70 years)

Gender (penempuan more often affected by OA of the knee, while men more often affected by OA of
the hip)

Impaired growth

Heriditer

extrinsic Factor
Obesity

Abnonomalis metabolk (prediposisi coronary heart disease diabetes mellitus, and hypertension)

lesion arising in the joints (fractures, avascular necrosis, ligament tear, damage fibrocartilage)

Factor job, fiik activity, and exercise is often done.

Source: SELEKTA capita MEDICINE FKUI

several risk factors for osteoarthritis are as follows:

• Women aged over 55 years, men aged> 65 years

• Being overweight (Obesity causes osteoarthritis by increasing the mechanical stress on the cartilage)

• excessive physical activity, such as athletes and manual workers

• Suffering from a thigh muscle weakness

• Have had a broken bone around the joints that are not getting proper care

(Bone and Joint Disease By Dr. Faisal Orphan DTM & H, MPH)

• Women aged over 65 years

• Being overweight

• excessive physical activity, such as athletes and manual workers

• Suffering from a thigh muscle weakness

• Have had a broken bone around the joints that are not getting proper care

Symptoms:

• pains in the joints that are affected after repeated use

• Joint pain is usually worse at the end of the day

• swelling, warmth, and creaking of the affected joints

• stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater
(Bone and Joint Disease By Dr. Faisal Orphan DTM & H, MPH)

6. What pathogenesis of osteoarthritis?

OA arising from metabolic disorders and keruskan cartilage proteoglycan with diverse etiology, one of
which dn chemical mechanical injury to the synovial joints.

When joints experiencing injury, there will be replication of chondrocytes and production of the new
matrix. Chondrocytes will synthesize DNA and collagen and proteoglycans.

However, degradation of collagen and proteins. Improved products martiks cartilage degradation will
gather in the joints causing inflammation.

In the patients with OA cartilage were also found increased activity of fibrinogen and fibrinolytic
aktiivitas decline.

Resulting in the accumulation of thrombus and lipid in the blood vessels, causing ischemia and
subchondral tissue necrosis.

Inflamai processes have led to chemical mediators causing the pain.

Source: SELEKTA capita FKUI

7. any investigation of scenario?

Laboratory tests: can ditemu peadangan signs. idak discovered immunological abnormalities on
examination. the results of laboratory tests on OA generally showed normal results, nor with
iunologinya examination.

radiological examination: X-rays of joints, MRI, artoskopi, or atografi. radiology that leads to OA:

Gap sendibmenyempit (asymmetric)

subchondral Sclerosis

ditemukanya crest on bone

Osteofit around joints: Heberden nodes (the DIP) and Bouchard nodes (pda PIP)
 sendo anatomical structure changed.

Source: SELEKTA capita FKUI

8. how the etiology of osteoarthritis?

Etiology:

primary osteoarthritis mostly linked to aging. With aging, the water content of the cartilage increases,
and protein composition of cartilage degeneration.

secondary osteoarthritis is caused by diseases or other conditions. Conditions that can lead to
secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal
joints at birth (congenital abnormalities)

Obesity causes osteoarthritis by increasing the mechanical stress on the cartilage

Tauma repeated on joint tissues (ligaments, bones, and cartilage) is believed to lead to early
osteoarthritis of the knees on the ball players.

(Bone and Joint Disease By Dr. Faisal Orphan DTM & H, MPH)

9. why the knee sound "crick" or crepitus while on the move?

10. What diagnosis and DD of scenario?

• AR (rheumatoid artristis): Chronic disorders, systemic inflammation that can affect many tissues and
organs, but principally attacks the joints produce inflammatory synovitis that often progresses to
destruction of articular cartilage and ankylosis of the joints.

The disease is most common between the ages of 40 and 50.

Symptoms:

signs of inflammation, with the affected joints become swollen, warm, painful and stiff, particularly early
in the morning waking or after a long period of inactivity. Increased stiffness in the morning is often a
prominent feature of the disease and may last for more than an hour.
• Disease. Gout: rheumatic diseases due to kinetic disorders of uric acid (hyperuricemia) acute articular
inflammation that causes severe pain.

A group of men at risk of suffering from gout arthritis.

in women, increased levels of uric acid began menopause because estrogen plays a role helping the
secretion of uric acid in the urine.

In patients aged over 65 years

Symptoms:

Acute attacks are usually monarticular (attack a single joint) with symptoms of swelling, redness, severe
pain, heat and movement disorders of the joints are attacked happened suddenly (acute) which reached
a peak in less than 24 hours. The location is most often in the first attack is the base of the big toe joint.
at midnight the patient feels severe pain

• Osteoarthritis: is a type of arthritis that is caused by damage or decay and eventual loss of cartilage
(cartilage) of one or more joints. commonly affects the hands, feet, spine (spine), and joints that hold
great weight, such as the hips and knees

11. how the management of these scenarios?

nonfarmakologi:

Lighting

That patients mengetaui sediit ins and outs about the disease, how to keep the disease from getting
worse and joints can still be used.

Physical therapy and rehabiltas

To melatihh patients to keep joints can be used and jasmine patients to protect a sore joint (reducing
pain)

Avoid obesity by keeping the body weight or lose weight to ideal

Reduces joint activities that stimulate excessive because it can cause pain

regular acupuncture therapy to relieve pain

 Famakologis

oral non-opiate Analgesic

Can be considered the use asetaminofrn, NSAIDs (ibuprofen, naproxen, san salicylate)

Anlgesik topical

Diclofenac sodium gel 1%

chondroprotective agent

Tetracycline, hialuroat acid, chondroitin sulfate, glycosaminoglycans, vitamin C, superoxide dismutase,

intra-articular steroids.

Source: IPD JILID III, & MEDICINE SELEKTA capita FKUI