Osteoarthritis Or Degenerative Arthritis

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Osteoarthritis (outline of this chapter)

Introduction

Risk factors

Signs and symptoms

Diagnostic tests

Treatment of osteoarthritis

[edit] Osteoarthritis or degenerative arthritis

Introduction:

Doctors have many synonyms for this disease: degenerative joint disease, degenerative arthritis, osteoarthritis or osteoarthrosis. All of these names mean the same thing and are used interchangeably here. They mean an inflammatory joint disease, which is the most common form of arthritis of the aging person. There is a change in the metabolism of the aging joint: before osteoarthritis sets in the cartilage cells, which form a smooth joint surface, are not dividing and they stay at their best performance when compression and release alternate. This way the nutrients and oxygen flow into the joint space and keep the lubrication of the joint originating from the lining of the joint (called synovium) in balance.

With the beginning of degenerative changes this balance breaks down and the cartilage cells start multiplying and producing pathological proteoglycans. Socalled cytokines are released, which stimulate the bone producing osteoblasts of the underlying bone to produce more brittle, stiffer bone and bone spikes (osteophytes) at the edges of joints.

This new bone formation is prone to microfractures and subsequent callus (new bone) formation. Eventually there is cyst formation underneath the diseased osteoarthritic joint, which can also be detected as a sign on X-rays. The joint dries up and there is loss of cartilage islands. This leads to joint pain and stiffness and to swelling of the lining of the joint ( called synovitis). In the end stages the synovial membrane can be so thick and edematous that the joint is extremely swollen and baggy, and there might be an accumulation of joint fluid, called effusion. Eventually bone rubs on bone, which feels like a joint crackling to the patient or the examining hand of the physician (Ref. 1).

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Arthritis

Osteoarthritis

References:

1. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 52.

2. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.

3. EL Cain et al. Clin Sports Med 2001 Apr;20(2):321-342.

4. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier