What is Osteoarthritis?

Osteoarthritis is a degenerative disease, which is caused by degenerative damage to the articular cartilage, joint margins and subchondral bone hyperplasia due to many factors such as aging, obesity, strain, trauma, joint congenital abnormalities, joint deformities, etc. Osteoarthropathy, degenerative arthritis, senile arthritis, hypertrophic arthritis, etc. The clinical manifestations are slowly developing joint pain, tenderness, stiffness, joint swelling, restricted mobility, and joint deformities.

Basic Information

nickname

Osteoarthritis, degenerative arthritis, senile arthritis, hypertrophic arthritis

English name

osteoarthritis, OA

Visiting department

orthopedics

Common causes

May be related to older age, women, obesity, overuse, etc.

Common symptoms

Joint pain, stiffness, swelling, restricted movement and deformity, etc.

Causes of osteoarthritis

According to the presence or absence of local and systemic pathogenic factors, osteoarthritis is divided into two categories, primary and secondary.

Secondary osteoarthritis

(1) Mechanical or anatomical abnormalities Hip joint abnormalities, femoral skull condyle slippage, femoral neck abnormalities, multiple epiphyseal dysplasia, old fractures, meniscectomy, joint replacement, acute and chronic injuries.

(2) Inflammatory joint diseases: septic arthritis, osteomyelitis, tuberculous arthritis, rheumatoid arthritis, serum-negative spinal arthropathy, Behcet syndrome, Paget disease.

(3) Metabolic abnormal gout, Gaucher disease, diabetes, progressive hepatolenticular degeneration, cartilage calciosis, hydroxyapatite crystals.

(4) Endocrine abnormal acromegaly, abnormal sex hormones, hyperparathyroidism, hypothyroidism with myxedema, and adrenal cortex hyperfunction.

(5) Neurological defects, peripheral neuritis, syringomyelia, and Charcot arthropathy.

2. Primary osteoarthritis

Its etiology is unknown and may be related to factors such as old age, females, obesity, and occupational overuse.

Clinical manifestations of osteoarthritis

The main symptom is joint pain, which often occurs in the morning. After the activity, the pain is reduced, but if the activity is too much, the pain can be aggravated. Another symptom is joint stiffness, which often occurs when you wake up in the morning or stay in a certain position during the day. Examination of the affected joints shows joint swelling and tenderness, friction or "click" sounds during movement, and severe disease may have muscle atrophy and joint deformities.

Osteoarthritis examination

Laboratory inspection

Synovial fluid is usually clear, slightly yellowish and highly viscous, and the white blood cell count is usually within 1.0 × 10 ⁹ / L, mainly monocytes. Mucin clot is solid.

2. Other auxiliary inspections

The plain X-ray film showed no obvious abnormalities in the early stage, and the joint space narrowing gradually appeared after several years, which indicates that the articular cartilage has begun to thin. At the beginning, the joint space is normal when not bearing weight, and narrows after bearing weight. In the late stage of the disease, the joint space is significantly narrowed, microfracture signs can be seen below the cartilage, and then osteoporosis occurs. Finally, the edge of the joint becomes sharp, and osteophytes form the load. There can be a osteocystic cavity under the cartilage. Sign. CT and MRI can detect abnormal changes in articular cartilage and subchondral bone at an early stage.

Osteoarthritis diagnosis

Based on chronic medical history, clinical manifestations, and X-ray findings, diagnosis is easier. If necessary, joint synovial fluid examination can be done to confirm the diagnosis. It should be clear from the medical history whether the lesion is primary or secondary.

Differential diagnosis of osteoarthritis

Rheumatoid arthritis

Frequent in 20 to 50 years old. Severe acute attack with mild systemic symptoms and a long duration. The affected joints are mostly symmetrical or multiple, and do not invade the distal interphalangeal joints. Early swelling of the joint is spindle-shaped, late dysfunction and ankylosing. X-ray examination of local or systemic osteoporotic articular surface to absorb bone healing ankylosing deformity. Laboratory tests showed rapid erythrocyte sedimentation and positive rheumatoid factor.

2. Ankylosing spondylitis

More common in young men aged 15 to 30 years. Slow onset, intermittent pain, and multiple joint involvement. Spine movement is limited, joint deformities, morning stiffness. X-ray examination showed that the sacroiliac joint space was narrow and blurred, and the spinal ligament was calcified, showing a bamboo-like change. Laboratory tests showed rapid or normal erythrocyte sedimentation, and HLA-B27 was positive. Rheumatoid factors are mostly negative.

Osteoarthritis Treatment

The main treatment of this disease is to reduce the weight of the joints and excessive large-scale activities to delay the progress of the disease. Obese patients should lose weight and reduce joint load. When the joints of the lower limbs are damaged, crutches or canes can be used to reduce the burden on the joints. Physiotherapy and proper exercise can maintain the range of motion of the joints. If necessary, splint braces and canes can be used to help control the symptoms of the acute stage. Anti-inflammatory and analgesic drugs can reduce or control symptoms, but should be used with caution after assessing patient risk factors and should not be taken for long periods. Chondroprotective agents such as glucosamine sulfate have the effect of relieving symptoms and improving function, while long-term administration can delay the structural progress of the disease. For advanced cases, under the condition that the whole body can tolerate surgery, artificial joint replacement is currently recognized as an effective method to eliminate pain, correct deformities and improve function, which can greatly improve the quality of life of patients.