rheumatology 1

Osteoarthritis Overview

• Commonly referred to as degenerative joint disease, associated with aging, wear and tear.

• Affects approximately 27 million people in the US.

• Leading cause of disability in the elderly; often impairs daily activities.

Risk Factors

• Age: Increased risk with aging.

• Gender: More prevalent in females, potentially due to estrogen effects.

• Obesity: Contributes to stress on joints and increases risk.

• Congenital Conditions: Conditions like congenital dysplasia or Perthes can elevate risk.

• Genetics: 50% of hand and hip OA cases link to hereditary factors.

• Lifestyle: Repetitive joint use due to occupation or sports increases risk.

Joint Anatomy and Function

• Cartilage: Provides cushioning and absorbs impact; loss of cartilage is an early sign of OA.

• Synovial Fluid: Reduces friction; hyaluronic acid is crucial for lubrication.

• Diseases Progression: Initial joint injury leads to cartilage fibrillation and bone spur formation.

Symptoms

• Pain during specific activities; stiffness usually dissipates within 30 minutes of activity.

• Possible joint deformities (e.g., varus or valgus in the knees).

• Patient may feel joint buckling due to weakness.

Diagnosis

• Primarily clinical based on symptoms; imaging may be used to confirm diagnosis.

• No specific labs for OA; inflammatory markers remain normal unless secondary issues arise.

• X-ray Findings: Joint space narrowing, osteophyte formation.

Treatment Strategies

• Lifestyle Changes: Weight loss and joint-use modification.

• Physical Therapy: Focus on strengthening muscles around affected joints.

• Medications: Topical NSAIDs, oral NSAIDs as needed for pain management.

• Injections: Corticosteroids or hyaluronic acid can provide relief.

• Surgery: Joint replacement is an option for severe cases.

Conclusion

• OA is characterized by gradual joint failure with various contributing factors, including mechanical stress, age, hormones, and genetics. Help manage symptoms through a mixture of lifestyle adjustments, therapeutic exercises, pain medication, and surgical options when necessary.