Osteoarthritis - Wikipedia, the free encyclopedia. Osteoarthritis (OA) is a type of joint disease that results from breakdown of joint cartilage and underlying bone. Initially, symptoms may occur only following exercise, but over time may become constant. Other symptoms may include joint swelling, decreased range of motion, and when the back is affected weakness or numbness of the arms and legs. The most commonly involved joints are those near the ends of the fingers, at the base of the thumb, neck, lower back, knee, and hips. Joints on one side of the body are often more affected than those on the other. Usually the symptoms come on over years. It can affect work and normal daily activities. Unlike other types of arthritis, only the joints are typically affected. Risk is greater in those who are overweight, have one leg of a different length, and have jobs that result in high levels of joint stress. In contrast to rheumatoid arthritis, which is primarily an inflammatory condition, in OA, the joints do not typically become hot or red. Weight loss may help in those who are overweight. Pain medications may include paracetamol (acetaminophen) as well as NSAIDs such as naproxen or ibuprofen. Stiffness is most common in the morning, and typically lasts less than thirty minutes after beginning daily activities, but may return after periods of inactivity. OA can cause a crackling noise (called . Occasionally, the joints may also be filled with fluid. As OA progresses, the affected joints appear larger, are stiff, painful and may swell, but usually feel better with gentle use but worse with excessive or prolonged use, thus distinguishing it from rheumatoid arthritis. In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly. OA at the toes leads to the formation of bunions, rendering them red or swollen. Some people notice these physical changes before they experience any pain, in part because the cartilage damage in OA is generally painless because cartilage is aneural. OA is the most common cause of a joint effusion of the knee. The water content of healthy cartilage is finely balanced by compressive force driving water out and hydrostatic and osmotic pressure drawing water in. The breakdown of collagen fibers results in a net increase in water content. Inflammation of the synovium (joint cavity lining) and the surrounding joint capsule can also occur, though often mild (compared to the synovial inflammation that occurs in rheumatoid arthritis). This can happen as breakdown products from the cartilage are released into the synovial space, and the cells lining the joint attempt to remove them. Other structures within the joint can also be affected. New bone outgrowths, called . The subchondral bone volume increases and becomes less mineralized (hypomineralization). The pain in an osteoarthritic joint has been related to thickened synovium. The typical changes seen on X- ray include: joint space narrowing, subchondral sclerosis (increased bone formation around the joint), subchondral cyst formation, and osteophytes. This is derived from the Greek roots pseudo- , meaning . Radiographic diagnosis results in diagnosis of a fracture within a joint, which is not to be confused with OA which is a degenerative pathology affecting a high incidence of distal phalangeal joints of female patients. A polished ivory- like appearance may also develop on the bones of the affected joints, reflecting a change called eburnation. Note the osteophytes, narrowing of the joint space (arrow), and increased subchondral bone density (arrow). Damaged cartilage from sows. Together, they are protected by a joint capsule lined with a synovial membrane that produces synovial fluid. The capsule and fluid protect the cartilage, muscles, and connective tissues. With osteoarthritis, the cartilage becomes worn away. Spurs grow out from the edge of the bone, and synovial fluid increases. Altogether, the joint feels stiff and sore. Osteoarthritis. Classification. EOA is a much less common, and more aggressive inflammatory form of OA which often affects the distal interphalangeal joints of the hand and has characteristic articular erosive changes on x- ray. Acetaminophen (also known as paracetamol) is recommended first line with NSAIDs being used as add on therapy only if pain relief is not sufficient. Monitoring for abdominal pain or black stool. Their appropriateness is uncertain, and opioids are often recommended only when first line therapies have failed or are contraindicated. A Cochrane review from 2. In ankle osteoarthritis, evidence is unclear. Evidence supports joint replacement for both knees and hips as it is both clinically effective. Since glucosamine is a precursor for a component of cartilage, it has been studied for prevention and treatment. The effectiveness of glucosamine is controversial. There is insufficient evidence to make a recommendation about the safety and efficacy of these treatments. Waiting list- controlled trials for peripheral joint osteoarthritis do show clinically relevant benefits, but these may be due to placebo effects. It is estimated that 8. OA by age 6. 5, although only 6.
By payer, it was the second- most costly condition billed to Medicare and private insurance. OA has been reported in fossils of the large carnivorous dinosaur Allosaurus fragilis. Some clinicians refer to this condition as osteoarthrosis to signify the lack of inflammatory response. Sprifermin is one candidate drug. There is also tentative evidence that strontium ranelate may decrease degeneration in OA and improve outcomes. Osteoarthritis Management Program Welcome. Thank you for choosing Hunters Hill Private Hospital for your hospital care. Owned and operated by Ramsay Health Care - one. Research is thus focusing on defining these early pre- OA changes using biological, mechanical, and imaging markers of OA risk, emphasising multi- disciplinary approaches, and looking into personalized interventions that can reverse OA risk in healthy joints before the disease becomes evident. Gene transfer strategies aim to target the disease process rather than the symptoms. A 2. 01. 5 systematic review of biomarkers for OA looking for molecules that could be used for risk assessments found 3. A review of biomarkers in hip OA also found associations with u. CTXII. Another problem with a systemic biomarker is that a patient can have OA in multiple joints at different stages of disease at the same time, so the biomarker source cannot be determined. Some other collagen breakdown products in the synovial fluid correlated with each other after acute injuries (a known cause of secondary OA) but did not correlate with the severity of the injury. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved 1. 3 May 2. Osteoarthritis and Cartilage. World journal of orthopedics. Best Pract Res Clin Rheumatol. Arthritis and Osteoporosis Victoria. Osteoarthritis; Gout; Lyme Disease. It may be helpful to discuss whether a structured weight management program in your community that offers education and.Arthritis Care Res (Hoboken). Rev Bras Reumatol (in Portuguese). Loss of chondrocyte differentiation block during ageing. Ageing Research Reviews. Osteoarthritis Cartilage. Chondroitin Sulfate Concentration and Chain Length, Water, and Ash Content. With special reference to unicompartmental replacement and osteotomy of the knee. Arthritis Research & Therapy. Journal of Musculoskeletal Medicine. Retrieved 1. 5 February 2. First Aid for the USMLE Step 1, 2. First Aid USMLE). Best Pract Res Clin Rheumatol. Suppl Management): S4. J Orthop Sports Phys Ther. Cochrane Database Syst Rev. Arthritis & Rheumatology. Annals of Internal Medicine. The Cochrane database of systematic reviews. Diseases and Conditions. The Cochrane database of systematic reviews. Retrieved 5 April 2. Comparing effectiveness, safety, and price. BMJ (Clinical research ed.). Lancet (London, England). Health Technol Assess. Applied Health Economics and Health Policy. Arthritis Research & Therapy. The Cochrane database of systematic reviews. Arthritis Research & Therapy. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. Arthritis Care & Research. The Cochrane database of systematic reviews. Cochrane Database of Systematic Reviews. Retrieved 2. 6 April 2. The Cochrane database of systematic reviews. Rheumatology (Oxford). Part I: Osteoarthritis. Annals of Internal Medicine. The Journal of bone and joint surgery. The Cochrane database of systematic reviews. It is unclear if there is a benefit or harm for HA as treatment for ankle OA ^Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie- Harris D, Gandhi R, Takhar K, Lum G, Chahal J (December 2. Archives of bone and joint surgery. The bone & joint journal. Best practice & research. Clinical rheumatology. Osteoarthritis Cartilage. The Cochrane database of systematic reviews. Bone and Joint Initiative. Seminars in arthritis and rheumatism. Best practice & research. Clinical rheumatology. Best. Bets.^Burdett N, Mc. Neil JD (Sep 2. 01. International journal of evidence- based healthcare. BMJ (Clinical research ed.). International journal of clinical practice. The best current evidence suggests that the effect of these supplements, alone or in combination, on OA pain, function, and radiographic change is marginal at best. Therapeutic advances in musculoskeletal disease. P & T : a peer- reviewed journal for formulary management. Archived from the original(PDF) on July 2. Arthritis Research & Therapy. Part II: focus on micronutrients and supportive nutraceuticals. Altern Ther Health Med. The Cochrane database of systematic reviews. Several other medicinal plant products, including extracts of Boswellia serrata, show trends of benefits that warrant further investigation in light of the fact that the risk of adverse events appear low. Cochrane Database of Systematic Reviews (1): CD0. Clinical considerations. Cochrane Database of Systematic Reviews (4): CD0. The Cochrane database of systematic reviews (3): CD0. A systematic review and meta- analysis of randomised placebo- controlled trials.
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