Within each joint, there is a smooth, white covering of the bone called the articular cartilage. Damage to this articular cartilage can occur through trauma, a result of repetitive small injuries or simply through the process of ageing. Damage to the cartilage through the process of ageing is known as Osteoarthritis (OA).
“Osteoarthritis is a group of overlapping distinct diseases, which may have different etiologies but with similar biologic, morphologic, and clinical outcomes. The disease processes not only affect the articular cartilage, but involve the entire joint, including the sub-chondral bone, ligaments, capsule, synovial membrane, and periarticular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, and full thickness loss of the joint surface.”
Primary Osteoarthritis – mostly related to ageing. With ageing, the water content of the cartilage increases and the protein makeup of the cartilage degenerates. Repetitive use of the joints over the years causes damage to the cartilage that leads to joint pain and swelling.
Secondary Osteoarthritis – is caused by another disease, condition or injury. Conditions that can lead to secondary osteoarthritis include, obesity, repeated trauma, or surgery to the joint structures, abnormal joints at birth, gout, rheumatoid arthritis, diabetes, and other hormone disorders.
Whether osteoarthritis is primary or secondary, the changes that occur in the joints are similar. Initially the articular cartilage softens. Subsequently the surface becomes uneven, and the cartilage ‘frays’ and develops cracks which may extend down to the bone beneath. Ultimately the cartilage is worn away to reveal the bone which then must serve as the loadbearing surface of the joint. With this the bone hardens an area of low density begin to form. New cartilage cells laid down around the worn cartilage become ossified, and bony projections are formed because of thickening of the joint capsule. The changes are seen most frequently in the hip and knee joints.
– Limited movement
– Sounds/Clicks/Grinding in joints
– Difficult and painful movements
– Morphological Deformities
– X-ray changes
Osteoarthritis is a degenerative process at the level of the cartilage and is diagnosed through a combination of subjective questioning, a physical examination and results from diagnostic imaging.
Information needed to help diagnose osteoarthritis includes:
– Description of the symptoms
– Location of the pain
– Limitations in activity
– When and how the symptoms began
– Other medical issues
– ROM tests
– Strength tests
– Joint tests
– Functional tests
– X-ray. X-rays can show damage and other changes related to osteoarthritis to confirm the diagnosis.
– MRI. An MRI will provide a view that offers better images of cartilage and other structures to detect early abnormalities typical of osteoarthritis
Osteoarthritic changes are clearly visible on x-ray examination carried out with the joint under load.
The changes of osteoarthritis cannot be reversed, but a variety of approaches may be adopted to relieve symptom and delay further degeneration.
– Reduce the load on the effected joint
– Active mobility and strengthening exercise should be carried out under the direction of a Physiotherapist.
– Bandages or braces may be used to relieve the load on the joints
– Hands-on treatment – Massage, Joint mobilisation or acupuncture could be very helpful in relieving pain.
– Anti-inflammatory and pain-relieving medication
– Surgery if there are severe degenerative changes
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