Osteoarthritis

Causes and Risks:
The cause of osteoarthritis is unknown, but metabolic, genetic, chemical, and mechanical factors may play a role in development. It is associated with the aging process and is the most common form of arthritis . It may first appear without symptoms between 20 and 30 years of age and is present in almost everyone by the age of 70. Symptoms appear in middle age. Before the age of 55 it occurs equally in both sexes; however, after 55 the incidence is higher in women. Approximately 4 out of 100 people are affected.

The cartilage of the affected joint is roughened and becomes worn down. As the disease progresses, so much of the cartilage is worn down that the bone ends start to rub against each other. Bony spurs may develop around the joint, causing pain and inflammation.

Systemic symptoms, sometimes associated with other arthritic conditions, are not associated with osteoarthritis. The joints of the hands and fingers, hips, knees, big toe, cervical and lumbar spine are commonly affected. The degeneration of the joint may occur as a result of injury or trauma to the joint, rheumatoid arthritis , occupational overuse, obesity , or metabolic diseases.

Prevention:
Weight reduction in women reduces the risk of developing knee osteoarthritis.

Symptoms:
  • gradual and subtle onset of deep aching joint pain

  • limited movement
  • grating of the joint with movement
  • painful bony growths in the finger joints
  • joint pain

+ may include:

  • joint inflammation (possible)

    • Note: There may be no symptoms.

    Signs and Tests:
    A physical examination may indicate joint changes.

    X-ray of the joints in the affected areas may show degenerative changes.

    Treatment:
    OVERVIEW:
    The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints, and minimize the disabling affects of the disease. The specific treatment depends upon the affected joint(s).

    MEDICATIONS:
    Medications used to treat osteoarthritis include a variety of nonsteroidal, anti-inflammatory drugs (NSAIDS). A two-week trial period is necessary to evaluate the benefit of a particular medication.

    Steroids, which are injected directly into the joint, may also be used.

    SURGERY:
    Surgical treatment to replace or repair damaged joints is indicated in severe, debilitating disease. Surgery options may include:

    • arthroplasty (total or partial replacement of the deteriorated joint with an artificial joint--see knee arthroplasty , hip arthroplasty )
    • arthrodesis (surgical fusion of bones, usually in the spine)
    • osteoplasty (scraping deteriorated bone from the joint)
    • osteotomy (change in the alignment of a bone to relieve stress on the bone or joint)

    LIFESTYLE CHANGES:
    Exercises are important to maintain joint and overall mobility. Physical therapists and occupational therapists can prescribe an appropriate home exercise treatment. Exercises in water are often effective for increasing mobility.

    Heat and cold treatments, protection of the joints, the use of self-help devices and rest are all recommended.

    Good nutrition and careful weight control are important. Weight loss for overweight individuals will decrease the mechanical strain placed on the joints of the lower extremities.

    OTHER THERAPY:
    Physical therapy or occupational therapy may be beneficial.

    Support Groups:
    The stress of illness can often be helped by joining a support group where members share common experiences and problems. See arthritis - support group .

    Prognosis:
    Disability with osteoarthritis is less common than with rheumatoid arthritis , but movement may become very limited. Treatment generally improves function.

    Complications:

    • joint deformities
    • disability



    Call Your Healthcare Provider:
    Call for an appointment with your health care provider if you have symptoms of osteoarthritis.

    Picture:
    P0072.pctBone X-ray


    Bone X-rays are a rapid way of determining the presence of fractures, dislocations, and other types of bone abnormalities. The procedure has the advantage of being painless and exposing the patient to only a small amount of radiation.