Osteoarthritis: Symptoms, Causes, Diagnosis

Osteoarthritis introduction

• Osteoarthritis is a joint inflammation that results from cartilage degeneration.
• Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
• The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use.
• There is no blood test for the diagnosis of osteoarthritis.
• The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function.
• Osteoarthritis is also known as degenerative arthritis or degenerative joint disease (DJD).

What is osteoarthritis?

Osteoarthritis is one form of arthritis where there is breakdown and eventual loss of the cartilage of one or more joints. Cartilage acts as a “cushion” between the bones of the joints. Osteoarthritis is the most common form of arthritis. Usually osteoarthritis occurs below 45 years of age in case of female and below 55 in case of male. Osteoarthritis occurs higher in Japanese, lower in South African blacks, East Indians and Southern Chinese.

Where does osteoarthritis affect?

• Hands
• Feet
• Spine
• Large weight bearing joints, such as hips and knees

What are the causes osteoarthritis?

There is no known cause of primary osteoarthritis.

Secondary osteoarthritis may occur due to

• Obesity, which causes excessive stress on weight bearing joints
• Aging, with which, the water content of cartilage increases and the protein makeup of cartilage degenerates.
• Repeated trauma or surgery to the joint structures
• Repetitive use of the worn joints over the years can irritate and inflame the cartilage.
• Abnormal joints at birth
• Gout
• Diabetes
• Other hormonal disease, such as growth hormone disorders.

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What are the symptoms and signs for osteoarthritis?

Symptoms of osteoarthritis vary from patient to patient. Some may have severe symptoms despite there is no significant x ray findings, some may have less or intermittent symptoms although having significant x ray findings.

• Osteoarthritis shows no systemic illness unlike other arthritic conditions such as rheumatoid arthritis.
• Osteoarthritis doesn’t affect other organs of body.
• Main symptom is joint pain, usually worse later in a day
• In osteoarthritis, there may be swelling, warmth over the affected joint
• Creaking of the affected joint
• Severe osteoarthritis may cause pain even at rest or with limited motion.
• Pain may be intermittent and interval period is not fixed, even few years interval is not uncommon.
• Heberden’s node may be found. It is a bony node occurs at the end of finger.
• Bouchard’s node may also be found. It is bony node occurs at middle joint of finger.
• Bunions may be found at feet.
• If osteoarthritis occurs at weight bearing joint, it may cause limping.
• In case of osteoarthritis of spine; pain, numbness and tingling may occur along the distribution of spinal nerve because osteophytes (bony spurs) may compress the nerve roots.

How is osteoarthritis diagnosed?

There is no blood test for the diagnosis of osteoarthritis but some blood tests are done to exclude diseases that can cause secondary osteoarthritis, also to exclude other arthritis conditions.

X-rays of the affected joints can be used to diagnose osteoarthritis. The common X-ray findings of osteoarthritis are:

•   Loss of joint cartilage
•   Narrowing of the joint space between adjacent bones
•   Bone spurs formation.

Simple X-ray testing can also be very helpful to exclude other causes of pain in a particular joint and also helpful decide if surgery is needed or not.

Arthrocentesis is also done to diagnose osteoarthritis. Arthrocentesis is a procedure to remove joint fluid. During arthrocentesis, a sterile needle is used to remove some joint fluid for analysis. Joint fluid analysis is useful to exclude gout, infection, and other causes of arthritis.

Arthroscopy is a surgical technique whereby doctor inserts a viewing tube into the joint space. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes they can be repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery more quickly than from open surgery.

Analysis of the location, duration, and character of the joint symptoms and the appearance of the joints also helps the doctor to diagnose osteoarthritis.

Treatment for osteoarthritis:

The conservative treatment includes rest, weight reduction, some exercises, drugs like NSAIDs, local anti-inflammatory spray, intra-articular steroid injections.

If conservative treatment fails, one should undergo surgery. Total replacement surgery is the treatment of choice.

For more about treatment of osteoarthritis, click here.