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Osteoarthritis
Osteoarthritis
What is osteoarthritis? It is the most common type of arthritis that develops due to the
When this happens it leads to bone break down because the bones within the joint start to rub
upon one another. This will cause changes inside and outside of the bone. The inside of the
bone will start to experience abnormal hardening (sclerosis), and the outside of the bone will
OA is from “wear and tear” on the body rather than from on overactive immune system, which
is the cause in rheumatoid arthritis (it affects the synovium NOT hyaline cartilage in RA).
What is bone cartilage? Bone cartilage is a rubbery, smooth tissue found within the joint that
covers the end of each bone. It acts as a protective mechanism for movement by providing this
slick surface for the bones to slide and glide during movement. In addition, it absorbs shock
from movement.
The top layer of cartilage begins to breakdown and wear away. This leads to a loss of joint
space within the joint, which allows the bones to grate upon each other. Therefore, there is no
longer this environment that allows for easy gliding of bones during movement without friction.
This leads to eroding of the bone and osteophyte formation. Furthermore, pieces of cartilage
and bone can break off and float around in the joint space. All of this leads to extreme stiffness
and pain.
OA is also called degenerative joint disease and remember it is the CARTILAGE NOT synovium.
It tends to most commonly occur in the hands, knees, hips, and spine (majorly the weight-
bearing joints which experience a lot of stress) and it does NOT affect other systems in the
body and it’s unsymmetrical (a patient can have OA in both correlating joints or just one).
Causes:
• Overweight
• Genetics
There is no cure. It gets worse overtime and damage can’t be reversed (cases vary mild to
severe).
Managed with lifestyle changes (exercise/losing weight), medication, surgery (hip/knee joint
No conclusive test to diagnose OA. Must evaluate patient’s signs and symptoms and rule out
other forms of arthritis such as gout, rheumatoid arthritis. X-ray imaging may be helpful
X-ray may show: sclerosis of bones, decreased joint space, osteophytes/bone fragments
“Osteo”
Outgrowths that are bony, especially on the hands due to bone spur formation (*remember the
• Heberden’s Node (most common): found on the distal interphalangeal joint (joint
• Bouchard’s Node: found on the proximal interphalangeal joint (middle finger joint)
Sunrise Stiffness (morning) LESS than 30 minutes (Remember RA is greater than 30 minutes)…
pain will be the worst at the end of day from overuse than compared to morning time
Tenderness when touching the joint site with bony overgrowths (joints will be BONY and
Experience grating (crepitus) of the bones when moving/flexing joint from bones rubbing
together and joint pain with activity which goes away with rest
Only the joints: Asymmetrical/Uneven , limited to joints (joint site will be hard and bony, NO
warmth or boggy synovitis with red inflammation) along with limited mobility, not system
Pain assessment: patient’s perception of the disease, effects of the disease on the patient’s
Therapy: physical exercise is one of the most effective treatments for OA….may help create
more lubrication to the cartilage allowing the pain and stiffness to decrease, strengthen
Exercise: this is the last thing most patients want to do but limiting activity and not exercising
leads to more pain, increased joint damage, increased weight, and decreased mental health.
Types:
o Strengthen training (lifting weights which helps strengthen muscles around the
joint)
o Range of motion exercises (ROM): improves the mobility of the joint and
decreases stiffness
AVOID: high impact exercise that will increase the stress on weight bearing
joints, such as running/jogging, jump rope, or any type of exercise where both
Physical therapy and occupation therapy (using assistance devices to decrease weight bearing
stress, exercise etc.), local support groups, structuring day to prevent overuse of joints
Medications:
the inflamed tendons and ligaments. Note: this is temporary relief of no more than a month or
two.
Pain relief: topical creams, Tylenol, NSAIDs (GI bleeding/ulcers), controlled substances (opioids
if severe)