May 26, 2008

Osteoarthritis & Gouty Arthritis

Posted in Category : Bone, Joint & Muscles Disorders

Osteoarthritis is a degenerative disease of disease of joints caused due to degeneration of protein substance in the joints namely cartilage. Different body parts such as feet, spine, hand, wrists and weight-bearing joints like knee and hip are affected by this disorder. It can cause pain, swelling, tenderness and inflammation in the joints. Gout (gouty arthritis) is a type of arthritis wherein an inflammation is caused by the deposition of uric acid crystals in the cartilage present in bone joints, surrounding tissues and tendons. It generally affects the joints of ankles and feet.

Osteoarthritis is mainly associated with aging, joint injuries, obesity, some genetic factors and inflammatory response. Diabetes, gout and some other hormonal disorders are also responsible for the development of osteoarthritis. In gout, there is deposition of uric acid crystals in the cartilage which may cause degeneration of cartilage resulting in the inflammation of joints. Some of the common causes of gout are higher levels of uric acid in the body, high alcohol intake, obesity, high intake of food containing purines, some medications used for the treatment of high blood pressure and long-lasting kidney disease.

Pain, stiffness, swelling and tenderness of the joints are the common symptoms of osteoarthritis. The cartilage breaks into small pieces due to rapid degeneration of cartilage and floats inside the joint fluid which causes an irritation to other soft tissues. As the disease progresses, there is inflammation in the joints due to total loss of cartilage. The bones start to rub on each other due to formation of bony spurs. While in gout, the joints of knees, ankles, elbows, fingers and wrists are affected. Common symptoms of gout are pain, swelling, warmth, tenderness and reddish discoloration of joints. In chronic condition of gout, there may be deposition of nodular masses of uric acid crystals in various soft tissue areas.

The diagnosis of osteoarthritis is done on the basis of symptoms, medical history, physical examination and some lab tests. Some of the useful investigations are blood tests to rule out other types of arthritis, analysis of joint fluid, x-rays and arthroscopy. On the other hand, the most reliable test for the diagnosis of gout is joint fluid analysis obtained by arthrocentesis (joint aspiration). Presence of uric acid crystals in the fluid indicates gout. X-findings in gout include crystal depositions and bone damage.

There is no cure for osteoarthritis, but the goal of treatment is to relieve pain, manage the symptoms and maintain the joint function. Various treatment options for osteoarthritis are medications like analgesics, non-steroidal anti-inflammatory drugs and cortisone shots, some exercises, physiotherapy and surgical options like fusing bones, osteotomy and joint replacement. While the treatment of gout includes the medications like non-steroidal anti-inflammatory drugs, corticosteroids, combined with aerobic exercise program and dietary changes.