Osteoarthritis is the progressive chronic inflammation of the joint that occurs as a result of wear and tear of the joint. Osteoarthritis is identified as the most common cause of joint pain. It is usually not symmetric destruction of the joints, unlike rheumatoid arthritis that is symmetric.
Osteoarthritis is not an autoimmune disease, but there is an immune response happening in the joint due to the gradual break down of cartilage and underlying bone.
Osteoarthritis is more common in women and occurs with age. The manifestations usually start gradually with exercise and intense physical activities but get worse over time, even with minimal activities. It usually affects the spine (lower back), knees, hips, and hand joints.
Here are signs and symptoms of Osteoarthritis:
- Joint pain that gets worse with activities and gets better with rest.
- Joint swelling, tenderness, and redness overlying joints
- Joint stiffness.
- Decrease the range of motion.
- Bouchard’s nodes: is the formation of hard bony outgrowths in the proximal interphalangeal joints
- Heberden’s nodes: is bony outgrowths in the distal interphalangeal joints.
- Back pains
- Crepitus (cracking sound when the affected joint is moved indicating the movement of 2 bones rubbing on each other)
Here are the risk common risk factors of Osteoarthritis
Osteoarthritis is the common prevalent form of arthritis in the world, affecting 3.3% of the world’s population (about 237million people worldwide). The risk increases with:
- Genetic predisposition.
- Age: being older.
- Sex: more common in women
- Being a post-menopausal woman
- Occupations that increases stress on joints such as heavy lifting, climbing stair regularly, climbing a ladder and long term is walking at work.
- Previous joint injuries.
- Malformation of joint (malformed joints from birth)
- Diabetes mellitus
- Ehlers-Danlos syndrome
- Lyme disease
- Wilson’s disease
- Marfan syndrome.
- Septic arthritis
Diagnosis Of Osteoarthritis Include:
- Full blood count
- Synovial fluid analysis (WBC per mm3 is <5000 and fluid is clear yellow)
- X-ray of joints will indicate:
- Joint space narrowing
- Subchondral cyst formation
- Subchondral sclerosis (increase bone formation around the joint)
- Magnetic resonance imaging (MRI)
Classification of Osteoarthritis:
According to cause:
- Primary Osteoarthritis: as a result of the long term used of joint with no specific underlying cause.
- Secondary Osteoarthritis: occur as an adjoining disease to another disease, for example, hemochromatosis, diabetes mellitus, or gout.
Uses questionnaires to assess Osteoarthritis of the knee and hip (stiffness, pain, and physical functions of joint).
According to the part of joints affected:
- Knee osteoarthritis.
- Hip osteoarthritis.
- Spine osteoarthritis.
- Combined Osteoarthritis.
Is a knee specific instrument used to assess patient’s opinion about their knees and the long and short term consequences of knee injuries
Tonnis grading scale of hip osteoarthritis:
|0||No signs of osteoarthritis|
|1||Slight narrowing of joint space. |
Slight lipping at joint margin.
Slight sclerosis of the femoral head or acetabulum.
|2||Small cysts in the femoral head or acetabulum. |
Increasing narrowing of joint space.
Moderate loss of sphericity of the femoral head.
|3||Large cysts. |
Severe narrowing or obliteration of joint space.
Severe deformity of the femoral head.
|GRADE||X- RAY FINDINGS|
|Grade I||Doubtful narrowing of joint space and possible osteophytes.|
|Grade II||Definite osteophytes and definite narrowing of joint space.|
|Grade III||Moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bone contour.|
|Grade IV||Large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone contour.|
Croft’s classification uses x-ray findings to grade Osteoarthritis. It has five grades of classification:
Treatment Of Osteoarthritis
Osteoarthritis cannot be cured or reversed, although the symptoms can be managed with the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen and naproxen sodium
- Analgesics: Acetaminophen.
- Physical therapy.
- Injection of corticosteroids directly into the joints
- Injections of hyaluronic acid for joint lubrication
- Knee joint replacement.
- Hip joint replacement.
- Lose weight
- Use of heat and cold compress to reduce swelling of joints
- Occupational therapy.
Lastly, this is an informative article about Osteoarthritis. If you encounter any Osteoarthritis symptoms, make sure to consult your doctor for proper checkup.