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Osteoarthritis: Difference between revisions
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(Created page with "<section begin="radiology" />'''Osteoarthritis''' (OA), also called '''degenerative joint disease''', is a common chronic disorder characterised by degeneration of joints. It's the most common type of arthritis. It usually affects weight-bearing joints like the knees, hips, feet, as well as joints of the spine and hands.<section end="radiology" /> == Diagnosis and evaluation == No laboratory test is available for OA. The diagnosis is made based on typical clinical f...") |
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<section begin="radiology" />'''Osteoarthritis''' (OA), also called '''degenerative joint disease''', is a common chronic disorder characterised by degeneration of | <section begin="orthopaedics" /><section begin="radiology" />'''Osteoarthritis''' (OA), also called '''degenerative joint disease''', is a common chronic disorder characterised by degeneration of the articular cartilage in the joint, causing friction and inflammation between bones. It's the most common type of [[arthritis]]. It usually affects weight-bearing joints like the knees, hips, feet, as well as joints of the spine and hands. It's a progressive disease.<section end="radiology" /> | ||
This article explains osteoarthritis in general. For details on the symptoms and managment of osteoarthritis for each type of joint, see [[wrist osteoarthritis]], [[osteoarthritis of the fingers]], [[hip osteoarthritis]], [[knee osteoarthritis]], and [[elbow osteoarthritis]]. | |||
== Etiology == | |||
* [[Prearthritic conditions]] | |||
* Old age | |||
* Overweight | |||
* Excessive joint loading | |||
== Pathomechanism == | |||
Stress -> cartilage damage -> cartilage degeneration -> loss of joint space and bony surface -> subchondral bone becomes sclerotic | |||
== Clinical features == | |||
* Pain and stiffness | |||
** Patient can hardly move joint in the morning | |||
** Patient needs a certain time to get the joint mobile and for the pain to disappear | |||
*** As the osteoarthritis progresses this takes longer and longer time | |||
** Stiffness and pain return in the evening | |||
*** As the osteoarthritis progresses the stiffness and pain return earlier and earlier in the evening | |||
** The symptom-free period during the day becomes smaller and smaller as the disease progresses | |||
* Limited ROM (contractures) | |||
** Occurs in any arthritis | |||
** Is more and more limited as the disease progresses | |||
* Swelling | |||
** Due to osteophytes and free fluid | |||
** When the synovial membrane gets irritated due to osteoarthritis it starts to produce too much fluid -> fluid can’t drain anywhere -> swelling | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
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* Joint space narrowing | * Joint space narrowing | ||
** Hyaline cartilage is translucent on x-ray, making it look like there is a space between the joint | |||
** When there is loss of hyaline cartilage it looks like the joint “space” becomes smaller | |||
* Subchondral sclerosis | * Subchondral sclerosis | ||
* Subchondral cysts | * Subchondral cysts | ||
* Osteophytes | * Osteophytes | ||
However, many of the above findings are present in asymptomatic people, and many people with clinically certain OA have few findings on imaging. It is therefore important to focus on the clinical findings for the diagnosis. Imaging may be used for follow-up or to rule out differential diagnoses.<section end="radiology" /> | However, many of the above findings are present in asymptomatic people, and many people with clinically certain OA have few findings on imaging. In other words, the severity of the x-ray findings do not correlate with the severity of the symptoms. It is therefore important to focus on the clinical findings for the diagnosis. Imaging may be used for follow-up or to rule out differential diagnoses.<section end="radiology" /> | ||
== Treatment == | |||
< | * NSAIDs – for pain | ||
* Joint replacement | |||
** See the articles for joint-specific osteoarthritis for details | |||
<section end="orthopaedics" /> | |||
[[Category:Orthopaedics]] | [[Category:Orthopaedics]] | ||