Diagnosis And Treatment In Rheumatology

Diagnosis And Treatment In Rheumatology

Diagnosis and Treatment in Rheumatology is a clear and concise handbook of all rheumatic diseases. The book presents organized information about current diagnosis, treatment and statistics (where ...
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Osteoarthritis

Pp. 190-207 (18)

Małgorzata Wisłowska

Abstract

Osteoarthritis (OA) is the most common type of arthritis. OA is the destruction of articular cartilage, subchondral bone, ligaments, joint capsules and periarticular tissues, sensory nerve endings, menisci leading to damage of the joint, limitation of motion and pain. Obesity, occupational trauma and muscle weakness are important biomechanical risk factors. Cartilage breakdown products increase synovial inflammation. OA mainly affects the elderly. Prevalence of osteoarthritis: 80% of patients over 55 years of age have radiographic evidence of osteoarthritis. OA is the result of active biochemical, biomechanical and cellular processes. OA is characterized by damage of the articular cartilage, osteophyte formation at the joint margins, subchondral bone sclerosis, and synovial and joint capsule thickening. These changes lead to joint degeneration and symptoms such as pain, tenderness, stiffness, loss of function and disability. OA develops mainly in the cervical and lumbar spine joints, hips, knees, first MTP, PIP, DIP. Risk factors of osteoarthritis are age, major joint trauma, repetitive stress and joint overload, obesity, congenital/development defects, prior inflammatory joint disease, metabolic changes and endocrine changes. Obesity is the main modifiable risk factor for OA. Pain or stiffness in and around one or more joints is the most common symptoms of OA. Radiological changes are narrowing of the joint space, subchondral bone sclerosis, bone cysts, osteophytes. Treatment OA include patient education, reduction of pain, optimization of treatment and modification of the degenerative process. First we use non-pharmacological methods, next topical capsaicin and topical NSAIDs, than acetaminophen, oral NSAIDs and finally arthroplasty.

Keywords:

Acetaminophen, Arthroplasty, Articular cartilage, Bone cysts, Cervical spine, DIP, Disability, First MTP, Hips, Joint capsules, Knees, Ligaments, Limitation of motion, Loss of function, Lumbar spine joints, Menisci, Narrowing of the joint space, Obesity, Occupational trauma, Oral NSAIDs, Osteoarthritis (OA), Osteophyte, Pain, Pain, Periarticular tissues, PIP, Sensory nerve endings, Stiffness, Subchondral bone, Subchondral bone sclerosis, Subchondral bone sclerosis, Synovial inflammation, Tenderness, Topical capsaicin, Topical NSAIDs.

Affiliation:

Head of Rheumatology and Internal Diseases Department CSK MSWiA Warsaw Poland.