OSTEOARTHRITIS

(Degenerative Joint Disease)

Franz Louis M. Evasco

V - BSOT
 A form of chronic
Arthritis

 Middle age and elderly

people

 Affecting especially the

weight bearing joints.
 Etiology
 Consists of a single major trauma or repeated
minor trauma
 Dystrophic
 Genetic factors
 Obesity
 Etiology
 Primary OA
- used to designate cases in which cause for
the joint disease is clearly apparent.

 Secondary OA
- antecedent disease or injury is believed to be
related to arthritis.
- may result from any condition that disturbs
normal joint function.
 Pathophysiology
 Early changes appear in articular
cartilage

 Cartilage lose some of its ability to

withstand mechanical stresses

 Swelling of the chondrocytes,

chondromucoid, softening of the matrix

 Cartilage undergoes splitting,

fibrillation, and gradual thinning
 Sign and Symptoms
 Early Stage
-stiffness of one or more jts associated with an
aching pain in or about the affected jt.

- nonarticular

- symptoms are worse in cold and wet weather

-Slight enlargement of the affected jts, slightly
tender on their margins

- Heberden’s nodes
common (DIP’s)
-Bouchards nodes
less frequent (PIP’s)
 Late Stage
- limitation of jt motion and disability

- pain may be present while the jt is at rest as

well as in motion

- crepitation

- moderate swelling and puffiness with loss of

normal jt contour.
 American College of Rheumatology
Classification Criteria for OA of the Hand

 Hand pain, aching, or stiffness and 3 or 4 of the ff. Features

- hard tissue enlargement or 2 or more of 10 selected jts.

- hard tissue enlargement of 2 or more DIP jts.

- fewer than 3 swollen MP jts.

- deformity of at least 1 of the 10 selected jts.

 Clinical Course
 Symptoms of OA usually exhibit a slowly
progressive and often intermittent course.

 In cases of mild to moderate degenerative joint

disease the patient is never severely
incapacitated.
 X – ray findings
 Narrowing of cartilage space

 Spurs, lipping, bridging between adjacent

vertebral bodies

 Hypertrophy or sclerosis of subchondral bone.

 Treatment (General Measures)
 Relieve the patient’s apprehension

 Adequate rest and protection of involved joints

from undue stress

 Teach to adjust physical activity to a level that

the affected joint or joints will tolerate.
Surgery
 Drug treatment
 Salicylates – relieves pain

 Aspirin

 NSAID’s – for patients who do not tolerate

aspirin
 OT Intervention
 For weight bearing jts. either restriction of
standing or walking or temporary use of crutches
or cane maybe indicated

 Maintain to increase joint mobility and strength

 Protect against or minimize the effect of

deformities.
 Increase understanding of the disease and the
best methods of dealing with physical, functional,
and psychosocial aspect.

 Assist with adjustment to disability

 Joint protection techniques to prevent pain
ex. Provision of elevated toilet seats or
adaptations to other chairs may be indicated.
Because sitting down and rising up from low
surfaces may be difficult and painful.

 Provision of adapted techniques and equipment

to maximize independence.
 Postoperative splinting and mobilization on late
stages