May 30, 2008

Osteoarthritis – Degenerative Joint Disorder caused by Loss of Cartilage

Posted in Category : Bone, Joint & Muscles Disorders

Among different forms of arthritis, osteoarthritis is one of the most common types. It is a degenerative disorder of the joints characterized by pain and inflammation of joints. It is caused by degeneration and eventual loss of cartilage present in the joints. The joints of feet, spine, hand, wrists, fingers and weight-bearing joints like knees and hips are commonly affected by this disease.

In most cases, the exact cause of osteoarthritis is not clear and this condition is known as primary osteoarthritis. When the cause is known, the condition is called as secondary osteoarthritis. Aging, obesity, joint injuries, some genetic factors and inflammatory response are some of the risk factors for osteoarthritis. Primary osteoarthritis is mainly related to aging in which water content of cartilage increases and protein base degenerates. Repetitive use of joints lead to irritation and inflammation of cartilage which may cause pain and swelling in joints. In advanced cases of osteoarthritis, there may be total loss of cartilage which may result in friction between the bones, joint pain and limitations in the mobility of joints.

Pain, swelling, tenderness and stiffness of the joints are the most common symptoms of osteoarthritis. With the progression of disease, the patient may experience pain, discomfort, swelling and stiffness in the joints especially early in the morning, while some people experience contraction in the tendons and muscle spasm. If the disease worsens, there may be development of some deformities in the joints leading to restriction in mobility. Grinding or cracking noise within the joint is one of the significant symptoms of osteoarthritis. Due to pain and deformities in joints, it may be difficult for a person to do daily activities.

When the disease becomes chronic and severe, it may cause some serious complications such as chndrolysis (inflammation of soft tissues), steonecrosis (bone death), stress fractures, bleeding inside the joint, infection in the joint, deterioration of ligaments and tendons, pinched nerve, sacroillitis, ganglion cysts, spinal stenosis, water on knee and Herberden’s and Bouchard’s nodes.

Physical examination, medical and family history of the patient, some laboratory investigations and imaging tests contribute a lot in the diagnosis of osteoarthritis. Blood tests like determination of rheumatoid factor (RF), determination of uric acid and detection of human leukocyte antigen (HLA-DR1 and HLA-DR4) are performed to rule out other forms of arthritis. Analysis of synovial fluid is also important investigation for diagnosing osteoarthritis. In addition to these laboratory investigations, imaging tests like x-ray are helpful to diagnose this disease. Common x-rays findings in osteoarthritis are narrowing of joint space, formation of bony spurs and formation of cysts.

The treatment of osteoarthritis is meant for relieving pain and inflammation and managing the symptoms. Various treatment options available are medications, different therapies, natural remedies and surgical options.  Medications for osteoarthritis include pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors. Various therapies including acupuncture, homeopathy, magnetic therapy, massage therapy, homeopathy, tai chi and yoga are also found to be effective for the treatment of osteoarthritis.