Image Source: Osteoarthritis Problem
Definition:-Osteoarthritis is a common chronic condition of articular cartilage degeneration. Secondary changes can occur in the bone, leading to pain, decreased functioning, and even disability.
∗Deep, aching character
∗Pain with motion early in disease
∗Ache with rest late in disease
∗Stiffness in affected joints
∗Resolves with motion, recurs with rest
∗Often related to weather
∗Limited joint motion
∗May result in constraints exercises of day by day living precariousness of weight bearing joints
Causes:-Osteoarthritis affects nearly 21 million middle-aged and elderly. It is the furthermost communal form of arthritis. Although not always symptomatic, most people older than the age of 55 years have radiological evidence of the disease. Until age 55 years, OA affects men more frequently than women, but after age 55, women are more likely to have the disease.
Osteoarthritis is a intricate disease connecting bone, cartilage and the synovial. It is generally believed to be an imbalance in erosive and reparative processes. There are a wide variety of factors predisposing an individual to this condition including the following:
∗Congenital abnormality such as Perth’s disease of the hip
∗Previous injury either owing to sport or work
∗General disorders such as acromegaly
∗Neuropathic joint syndrome such as a Charcot joint
Risk factors: – for Osteoarthritis include joint trauma, progressive age, female gender, obesity, heredity, congenital, muscle weakness or developmental anatomical defects, and repetitive stress.
Many age-related changes contribute to the development of Osteoarthritis.
»The strength of tendons, ligaments, and muscles declines with advancing age and may contribute to the development of the disease.
»The number of chondrocytes declines owing to apoptosis (cell death), decreased proliferation, or both.
»The synthesis of normal proteoglycans is reduced.
»Chondrocytes lose the ability to promote healing and cartilage remodeling, resulting in cartilage matrix degradation. Proteoglycans are depleted.
»Matrix metalloproteinase (MMPs) and proinfl amatory cytokines promote cartilage degradation.
»Induction of chondrocytes and synovial cells to synthesize MMPs
»Inhibits the synthesis of type II collagen and proteoglycans, preventing collagen from repairing itself
»Enhances nitric oxide production and induces chondrocyte apoptosis
»Pain occurs as a result of
»Osteophytes (spurs of cartilage and bone at the joint)
Physical examination:- Joint tenderness, diminished range of motion, crepitus, and misshaped joints.
Laboratory tests:- No specific lab tests are diagnostic for OA; however, if arthrocentesis is performed, synovial fluid will reveal mild leukocytosis with predominance of mononuclear lymphocytes.
Radiography: – Narrowing of joint space (owing to loss of cartilage), subchondral sclerosis, and osteophytes are seen.
The Criteria for Osteoarthritis of the hip, knee, and hand:
Osteoarthritis of the hip is characterized by hip pain and at least two of the following:
»Erythrocyte sedimentation rate (ESR) <20 mm/hours.
»Radiographic evidence of femoral or acetabular osteophytes
»Radiographic evidence of joint space narrowing
»Osteoarthritis of the knee is characterized by knee pain, radiographic evidence of
Osteophytes and at least one of the following:
»Age >50 years
»Morning stiff ness that lasts <30 minutes
»Articular crepitus on motion
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