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Osteoathritis

Academic Paper Review   by:Mngumi     Original Author: Dr. Mngumi BE.
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 OSTEOARTHRITIS.

Synonym: Degenerative arthritis.

Definition

Osteoarthritis is a type of arthritis that is characterized by the progressive breakdown (erosion) and eventual loss of the cartilage of one or more joints.

 Etiology.

May arise from unknown causes (idiopathic) or due to aging.

Secondarily due to known causes (i.e. precedes the underlying primary problem).

  • Repeated trauma to a joint.
  • Congenital developmental deformity of a joint.
  • Systemic diseases such as diabetes, onchronosis, hemochromatosis, and marked obesity

Pathogenesis.

  • Aging and mechanical stress that result in overuse of the articular cartilage.
  • Genetic factors play role in susceptibility to osteoarthritis especially in cases involving the hands and hips. Osteoarthritis can be found in multiple members of the family, implying a hereditary (genetic) basis for this condition. However the specific gene for the condition is not yet identified but it is linked to the chromosomes 2 and 11.Osteoarthritis risk is directly related to the bone density and estrogen levels in the body.

 The health of the chondrocytes and their matrix determine joint integrity. In osteoarthritis the healthy of these components are disturbed by a variety of influences as discussed above. Osteoarthritis is characterized by significant changes in both the composition and the mechanical properties of cartilage.

 Occurrence in a person.

  • Large weight bearing joints are more affected
  • Hips, knee, lower lumber and cervical vertebrae, proximal and distal interphalangeal joints, and tarsometatarsal joints of the feet.
  • Gender has some influence on the distribution of the condition

-Women: Knee and hands.
-Hips: Males.

  • Osteoarthritis before the age of 45 is seen most commonly in males and after 55 years is common in females.
  • Whites (western counties) are more affected than Africans

 Clinical course.

Osteoarthritis is an insidious disease, with most patients being asymptomatic until they are in their 50’s.If a young patient has a significant manifestation of osteoarthritis, a search for some underlying cause should be made.

Symptoms include:

  • Deep,archy pain that worsen with use
  • Morning stiffness.
  • Crepitus.
  • Limitation of range of movement.
  • If the spine is involved, compression of the nerve roots result I neurological signs

-pain
-muscle spasms
-muscle atrophy
-other neurological defect.

  • Characteristically in women only are the nodes of fingers (called Heberden nodes) representing prominent osteophytes at the distal interphalangeal joints.

 Gross features.

  • In early stage the articular cartilage is granular and softer than normal.
  • Later the cartilage is sloughed, exposing the subchondral bone (this becomes new articular surface).Friction smoothes and burnishes the exposed bone giving its appearance of a polished ivory (Bone eburnation).
  • Subchondral cysts.
  • Osteophytes bone outgrowths) at the margin of articular surface.
  • Small fractures through the articular bone. These cartilage fragments tumble into the joint forming loose bodies called joint mices.

Radiographic features

  • Narrowed joint space.
  • Subchondral sclerosis.
  • Scattered radiolucent cysts.
  • Osteophytes.
  • Joint mices.

Diagnosis.

  • Clinical course.
  • Radiography

Treatment.

No means to either prevent or methods for halting its progression. he disease may stabilize for years at any stage but more often is slowly progressive over the remaining years of life. Osteoarthritis is the 2nd only to cardiovascular diseases in causing long-term disability.

Published: May 30, 2008   
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