OSTEOARTHRITIS

Osteoarthritis is a degenerative bone disease characterized by loss of articular (joint) cartilage and
abnormal formation of new bone (bone spurs). The process involves low-grade inflammation, articular
cartilage calcification, genetic alterations, and metabolic disorders. Cytokines, matrix molecules, growth
factors, and enzymes play a role in the degenerative process. Without cartilage buffering, the underlying
bone is irritated, leading to degeneration of the joint. Osteoarthritis may develop idiopathically (for no
known reason) or may occur after trauma, with repeated stress such as that experienced by a long-
distance runner or ballerina, or in association with a congenital deformity. Individuals with hemophilia
or other conditions characterized by chronic joint swelling and edema may develop osteoarthritis.
Osteoarthritis is common in the elderly, affecting more than 70% of men and women older than the age
of 65. The occurrence in males and females is about equal, but females tend to have more severe cases.
Obesity can worsen the condition.

Clinical Manifestations

• Pain and stiffness in one or more of the joints, commonly the hands, wrists, feet, knees, upper and
lower spine, hips, and shoulders. Pain may be worse with weight-bearing.

• Pain may be associated with tingling or numbness, especially at night.

• Swelling of the affected joints, with a decreased range of motion. Joints may appear deformed.
Crepitus or grating sound with movement.

• Heberden nodes, bony growths on the distal interphalangeal joints of the fingers, and Bouchard nodes
on the proximal interphalangeal joints, may develop.

Diagnostic Tools

• Arthroscopy (visualization of the joint through a fiber-optic instrument), MRI, and CT scan may support
the clinical diagnosis.

Treatment

• A balance between resting and exercising the joints, geared toward minimizing inflammation but
preserving range of motion, is helpful.

• Assistive devices to ease weight-bearing.

• Weight loss for those overweight.

• Analgesics and anti-inflammatory drugs to reduce swelling and inflammation.

• Nutraceuticals such as glucosamine and chondroitin may slow progression and ease pain.

• Intra-articular injections of high-molecular-weight viscose supplements.

• Surgery may be required to correct a deformity or replace a joint.