About Osteoarthritis
Osteoarthritis is one of the more than 120 forms of arthritis which can occur in patients. Osteoarthritis, also known as OA, osteoarthrosis, or degenerative joint disease (DJD), is the type of arthritis that almost everyone develops in their lifetime. It is a form of arthritis that develops gradually, usually occurring sometime after the age of 45. OA is usually chronic in nature but fortunately occurs most frequently as a relatively mild condition. Some patients, however develop more severe symptoms requiring treatment and even joint replacement.
Who develops osteoarthritis?
Osteoarthritis is seen in both females and males in a 3:2 female/male ratio. Occurrence is usually noted between the ages of 45-90, and affects more than 20.7 million Americans today.
What exactly is osteoarthritis?
Osteoarthritis is the type of arthritis involving the cartilage of a joint. The cartilage of a joint is a tough, gristle-like material which is found on the ends of the bones. It forms the surface of the joint on either side. Cartilage is durable and somewhat elastic. It does not have a blood supply and therefore gets its oxygen from the joint fluid surrounding it. When you use a joint, fluid and waste products are removed from the cartilage by the pressure involved. When pressure is relieved, oxygen and other nutrients are returned to the cartilage. Cartilage also has no nerve supply. It is this characteristic that allows large forces to be transferred without pain. Over time, the cartilage may become worn. The bony surface of the joint may begin to grate against the bone on the other side and the elasticity of the cartilage may be decreased. Eventually the cartilage may wear away entirely. This cartilage deterioration is, in fact, what defines osteoarthritis. Unlike some other types of arthritis, OA does not affect the whole body. However, the changes which it can cause may limit patients due to pain and loss of movement.
OA can occur in any joint and may occur only on one side of the joint. Usually it is seen in the joints of the fingers, spine, hips, and knees. These joints fall into three common types of osteoarthritis(1). The first and usually mildest is the OA which affects the hands, causing knobby enlargement of the finger joints. When this occurs at the end joints of the fingers, these enlargements are called Heberden's nodes. Growths in the middle of the fingers are called Bouchard's nodes. This type of OA may cause stiffness and changes in the cosmetic appearance of the hand.
The second type of OA involves the spine. This can involve the neck area as well as the back. Bone spurs are symptoms of arthritis not necessarily the cause of pain.
The third type of OA commonly seen involves the weight-bearing joints, most frequently the hips and knees. This form of OA can become quite severe and limiting, or may only periodically cause symptoms. In extreme cases walking may become extremely difficult or impossible. This type of OA frequently involves both sides of the body, and may cause a deformity in the lower extremity due to the degeneration process.
When does osteoarthritis occur?OA can develop as a natural process of aging or it may occur as a result of a traumatic injury such as a fracture. Patients who have a congenital malformation of a joint also tend to develop OA at an earlier age than normally seen.
A common idea in past years was that osteoarthritis developed because of "wear and tear" or over-use of a joint. Research studies of people who participate in strenuous activities have failed to show a relationship between these activities and the development of arthritis. Furthermore, most experts agree that a patient, even when diagnosed with OA, needs to continue a program of exercise to maintain optimal function of the joint.
Why does osteoarthritis occur?
No one knows for sure what causes osteoarthritis. Some experts believe that people are born with defective cartilage or abnormalities in their joints which lead to the changes seen in OA. Others believe that OA develops as a result of over-using an already injured joint or because of joint damage caused by other arthritic conditions. Research into the causes, prevention, and treatment of OA as well as other types of arthritis continue to provide improved methods for the relief of symptoms and will continue to aid in the understanding of these disease processes.
Diagnosis
As mentioned earlier, there are over 120 types of arthritis. Correctly diagnosing the type of arthritis a patient has may take several visits to a physician and perhaps a referral to a rheumatologist, a physician who specializes in the diagnosis and treatment of people with various forms of arthritis. While OA can be slow to cause any noticeable symptoms, once symptoms occur it is important that a physician be involved in your care. By seeking medical attention early, you may prevent or decrease serious joint damage. You also will be able to work with your physician in developing a treatment plan which is individualized for your needs and tailored to your lifestyle.
Signs and symptoms of osteoarthritis can be difficult to assess, however, it is important to make a diagnosis of OA correctly to ensure the optimum treatment plan. The American College of Rheumatology has established guidelines for the diagnosis of OA2. These guidelines, included in Table 1 and Table 2 establish the classification criteria as well as the signs and symptoms of OA. As indicated by these tables, diagnosis is based on patient history and exam, blood tests, and x-rays. Certainly if you or a family member are demonstrating any of these symptoms you should strongly consider a formal visit to your physician.
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