"Skeletal Diseases"

Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a “cushion” between the bones of the joints. Osteoarthritis is also known as degenerative arthritis.

Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. Most cases of osteoarthritis have no known cause and are referred to as primary osteoarthritis.

Types

Primary when is directly caused by a factor

Secondary: when is an effect of an other disease (obesity, diabetes, gout etc)

Causes

Primary osteoarthritis is mostly related to aging and thus with the loss of water content in the catilage. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs) to form around the joints.

Osteoarthritis occasionally can be found in multiple members of the same family, implying an heredity (genetic) basis for this condition.

Secondary osteoarthritis is caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at birth (congenital abnormalities), gout, diabetes and other hormone disorders.

Symptoms

The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion.

Diagnosis

1. Blood test are performed only to exclude other diseases, that can cause secondary osteoarthritis
2. X-rays often corectly suggest osteoarthritis
3. Arthrocentesis = a procedure in which a sterile needle is used to remove joint fluid for analysis ( in order to exclude gout, infections or any other causes )
4. Arthroscopy is a surgical technique whereby a doctor inserts a viewing tube into the joint space. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery much more quickly than from open joint surgery.
5. Is very important to take into consideration the location, duration, the kind of sympomts the patient suffers from.

Treatment

Before starting teatment is very important to follow the doctors advice, which may include:

1. loosing weight
2. avoiding activities that exert excessive stress on the joint cartilage

The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function.

1. Exercise usually does not aggravate osteoarthritis when performed at levels that do not cause joint pain. Exercise is helpful in osteoarthritis in several ways. One could try: swimming, walking, stationary cycling, and light weight training.
2. Physical therapists can provide support devices, such as splints, canes, walkers, and braces. These devices can be helpful in reducing stress on the joints.
3. Medicins :

Among mild pain relievers there are: aspirin and acetaminophen (Tylenol), which may be sufficient treatment.

Medicine to relax muscles in spasm might also be given temporarily.

Pain-relieving creams applied to the skin over the joints can provide relief of minor arthritis pain - capsaicin (Arthricare, Zostrix), salycin (Aspercreme), methyl salicylate (Bengay, Icy Hot), and menthol (Flexall).

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that are used to reduce pain and inflammation in the joints. Examples of NSAIDs include aspirin (Ecotrin), ibuprofen (Motrin), nabumetone (Relafen), and naproxen (Naprosyn). It is sometimes possible to use NSAIDs for a while and then discontinue them for periods of time without recurrent symptoms, thereby decreasing side effect risks.

The most common side effects of NSAIDs involve gastrointestinal distress. The risk of these and other side effects increases in the elderly.

Some studies, but not all, have suggested that the food supplements glucosamine and chondroitin can relieve symptoms of pain and stiffness for some persons with osteoarthritis.

Sometimes are prescripted: cortisone or hyaluronic acid (Synvisc, Hyalgan) injected into the joint

1. Others: Surgery is generally reserved for those patients with osteoarthritis that is particularly severe and unresponsive to the conservative treatments. Arthroscopy, can be helpful when cartilage tears are suspected. Osteotomy is a bone removal procedure that can help realign some of the deformity in selected patients, usually those with knee disease.

Links:

http://www.arthritis.org/disease-center.php?disease_id=32

http://www.arc.org.uk/arthinfo/patpubs/6025/6025.asp

http://www.mayoclinic.com/health/osteoarthritis/DS00019

http://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp

This entry was posted on Friday, May 9th, 2008 at 1:16 am and is filed under Diseases. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.