Degenerative Arthritis - Osteoarthritis

Osteoarthritis is the most common joint disease and represents a heterogeneous group of pathological conditions common radiological and histopathological changes. It is a degenerative disease that occurs through biochemical destruction of the articular cartilage of synovial joints. Although osteoarthritis is considered to be the consequence of excessive weight and cartilage tears, secondary nonspecific inflammatory changes also affect the joints.By definition, the etiology of primary osteoarthritis is unknown, but the pathology and pathogenesis of osteoarthritis has been studied extensively.
History osteoarthritis has been divided into primary and secondary, although this division is artificial. Secondary osteoarthritis is more easily understood. It refers to degenerative disease of synovial joints with predisposing conditions, trauma that alters articular cartilage or subchondral bone. Secondary osteoarthritis occurs in younger people.The definition of primary osteoarthritis is unclear. Idiopathic is a phenomenon that occurs in joints intact, without apparent initiator factor. It is associated with the aging process and typically occurs in older people. Some doctors limit the disease in the hand joints, particularly the interphalangeal, while others include knee, hip, spine.
Osteoarthritis occurs with high incidence in elderly patient progresses. Primary Osteoarthritis is a common disease of old people and patients are usually asymptomatic. 80% of people over 65 years shows signs of primary osteoarthritis. Patients with symptoms not only notifies you after the age of 50 years. The prevalence of disease increases dramatically after 50 years, after this age due to alterations of collagen and by decreasing the intake of nutrients for cartilage proteoglycans and alterations incurred.Osteoarthritis typically develops slowly and progressively in a few years. The pain usually gets worse slowly, but it may stabilize in some patients. Knee osteoarthritis is a leading cause of disability in the elderly.
Today there are several treatments available to slow or stop progression of this common disease. The patient will avoid the application of mechanical pressure on the joints affected and will lose weight if they are overweight. Physical therapy may be recommended to preserve joint motion and flexibility. And acetaminophen are prescribed anti-inflammatory to relieve pain associated with the disease. Intra-articular pharmacological therapy includes administration of corticosteroids and viscosuplimentare injections. If these therapies are ineffective surgical intervention with total arthroplasty or arthroscopic procedures.
Pathogenesis of degenerative arthritis (osteoarthritis)Normal articular surface of synovial joints composed of hyaline cartilage consists of chondrocytes surrounded by extracellular matrix that includes different macromolecules, the most important being proteoglicanii collagen. Pretejeaza cartilage subchondral bone by distributing mechanical load, maintain limited contact and reduce friction joints.A variety of factors, particularly age, leading to the development of primary osteoarthritis, however, primary and secondary osteoarthritis are not separable as a pathological basis. Most scientists believe that degenerative alterations begin in the articular cartilage as a result of excessive mechanical loading of the joint healthy or normal loading of the affected joints. External forces accelerate the catabolic effects of chondrocytes and cartilage matrix interrupt.
Enzymatic degradation of cartilage destruction increases, accompanied by a decrease in proteoglycans and collagen synthesis. Changes in cartilage proteoglycans are less resistant to compressive forces from the joint and more succeptibil to stress.Cystic degeneration of subchondral bone trauma suffered by secondary bone necrosis or chronic impactarii intrusion of synovial fluid. In areas without pressure along the edge joint, bone marrow vasculature, bone metaplasia of synovial tissue and cartilage ossification lead to the formation of protrusion of bone spurs. Their fragmentation or cartilage leads to the formation of intra-articular foreign bodies.Causes and risk factors for arthritis:-Old age, obesity, female sex-Trauma, infection, repetitive occupational trauma-Genetic factors, history of inflammatory arthritis-Neuromuscular disorders, metabolic.
Signs and symptoms in osteoarthritis:Primary Osteoarthritis occurs mainly at the hand, the distal interphalangeal joints, proximal and first metacarpophalangeal.Also some people may start to take place in knee, hip, neck or low back region.Deep pain in the form of cramps, joint physical activity is the first symptom. Movements and also reduces crepitantele are commonly present. Malaliniamentul joint may be visible. Bone spurs can palpate the distal interphalangeal joints, characteristic of women. Inflammatory changes are typically absent or weakly pronounced.Pain:-Is the main reason that patients see a doctor-Initially symptomatic patients experience pain during activity, relieved by rest and that responds to simple analgesics-Morning stiffness lasts less than 30 minutes-Stiffness may develop during the rest-Joints can become unstable as the osteoarthritis progresses, pain is so prevalent and no longer respond to medication.
Pain in osteoarthritis is initiated by:Epansamentele-articular and articular capsule stretchingVascular pressure-increase in subchondral boneInflammation of the peri-stockPeri-muscle spasm-Psychological factors-Palpated crepitus during movements in the affected joint.
Subsets of primary osteoarthritis:Some diseases are categories or subsets of primary osteoarthritis. These include primary generalized osteoarthritis, erosive osteoarthritis and inflammatory Petelea Chondromalacia.Primary generalized osteoarthritis:Cluster is characterized by premature onset familial and Bouchard and Heberden nodules, as early degeneration of articular cartilage of multiple joints, including carpometacarpiana, knee, hip and spine. Radiographic appearance is similar nonfamiliala form of osteoarthritis, although the disease progresses rapidly and is severe.Erosive osteoarthritis:Primary osteoarthritis is a form marked by a high degree of inflammation, with abnormalities and erosive bone stiffness in some cases. The disease occurs mainly in postmenopausal women and may be hereditary. It is typically bilateral and symmetrical and distal interphalangeal. Rarely patients may have erosive osteoarthritis of the first metacarpal at the base or foot.Radiographic erosions are centrally located from the marginal rheumatoid arthritis. Bone spurs are present. It is obvious soft tissue swelling and bone fusion joint that limits movement.Chondromalacia patella:Occurs mainly in young adults. It is a syndrome with crepitus and pain associated with previous knee cartilage changes over the surface of the patella.