Hello and welcome to the Zero to Finals podcast and welcome to the brand new series on rheumatology.

My name is Tom and in this first episode of the new series I'm going to be talking to you about osteoarthritis.

And if you want to follow along with written notes on this topic, as always, you can follow along

at zero definals.com slash OA or in the rheumatology section of the zero to finals medicine book.

Let's get straight into it. Osteoarthritis is often described as wear and tear in the joints.

It's not an inflammatory condition like rheumatoid arthritis

and it occurs in the synovial joints and it's a combination of genetic factors, overuse and

injury to the joint. Risk factors for osteoarthritis include obesity, increased age,

occupation, particularly occupations where there's a high usage of particular joints, trauma to the joint, being female, and also a family history

of osteoarthritis. It's thought to be the result of an imbalance between the cartilage being

worn down and the chondricites repairing that cartilage.

And this leads to structural issues within the joint that causes more wear and tear and pain.

These abnormalities can be seen on an x-ray.

And the key mnemonic for remembering the four key x-ray changes in osteoarthritis

is loss, L-O-S-S. So L-O stands for loss of joint space. So the joint space and the joint

becomes narrower and the bones come closer to each other. O is for osteophytes and osteophytes are little spurs of bone that come out

of either end at the joint. The first S is for subarticular sclerosis and this has increased density

of the bone along the joint line where the bones come in contact with each other. And the second S is for subcondral cysts,

and these are small fluid-filled holes in the bone along the joint line.

X-ray changes do not necessarily correlate with the symptoms,

so you might find significant x-ray changes,

incidentally in someone who doesn't have symptoms.

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