Osteoarthritis (arthritis) 4.48/5 (54)

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Osteoarthritis of the outer joints of the fingers. Marshall M, Arthritis Care Res (Hoboken) (2014). CC BY 3.0

Osteoarthritis or arthritis in English. (ICD-10 M15.0)

Definition

Osteoarthritis is also called osteoarthritis and causes joint pain. The symptoms may be similar rheumatoid arthritis (RA), Psoriatic arthritis, SLE and other connective tissue diseases. Primary osteoarthritis (with no particular cause) is often separated from secondary osteoarthritis (after previous joint damage). Osteoarthritis between vertebrae in the neck and back is called spondylosis.

Occurrence

Osteoarthritis is the most common cause of disability among older people.

  • In some, osteoarthritis begins earlier, which may be due to genetic predisposition (inheritance) or previous joint damage
  • In the age group 35-54 years, approx. 5% symptoms of osteoarthritis, while at the age of 50-70 years the equivalent is approx. 8%. Not everyone has symptoms. On closer examination, osteoarthritis of the knees is found in every third person over the age of 65
  • Women get osteoarthritis a little more often than men

Disease Cause

  • Genetic disposition
  • Previous injuries (10-XNUM years before symptoms)
    • Sports injuries
      • Meniscus, crossband injury
    • Fractures
  • Previous arthritis (Arthritis)
  • Overweight (hips, knees, tired)
  • Weak muscles
  • Wear on joints due to overload (osteoarthritis) is today a rare cause

Osteoarthritis affects DIP and PIP joints in hands, but not MCP joints that are attacked by rheumatoid arthritis. Wikipedia. CC BY-SA 4.0,

The joints that are most commonly attacked

Osteoarthrtitis

Osteoarthritis is often attacked by knees. Illustration: Pixabay

  • Fingers (outer joints (Heberden knots), intermediary (Bouchard knots) and thumbs CMC1 (Third sectional area from the thumb's fingertip, quite close to the wrist)
  • Toes (big toe) (second joint from the outher-most) = hallux valgus when deviation is present)
  • Knee (gonartrose)
    • The incidence is believed to have doubled over the past ten years
    • Contributing factors are higher life expectancy, inactivity and weight gain. Past sports injuries can also be significant
  • Hips (coxarthritis)
  • Back (spondylosis, spondyloarthritis, spinal stenosis)

Symptoms of osteoarthritis

  • Joint pain (arthralgia)
  • Stiffness
    • Especially after being in peace
  • Reduced mobility
  • Raspy or crushing sound in the joints
  • Unstable joints
  • Bony thickness around the joint

Diagnosis

  • Symptoms
  • Clinical examination of joints
    • Bony thickening, instability, creepitations / scratches by motion
  • X-ray, CT or MRI examinations
  • Blood tests are expected to be normal
Hip-Osteoarthritis

X-ray osteoarthritis of the hip: Tower Time TD, 2011. CC Openi

Incorrect diagnosis? (Similar diseases / differential diagnoses)

Arthritis (RA)

  • More "warm" inflammed joints
  • Multiple joints are attacked at the same time
  • Most often, the in knuckles of the hands
  • Wrist
  • Base joint of the toes (MTP) (corresponds to the knuckles / MCP joints of the fingers)
    • Feels like "walking on pillows"
  • Ankles
  • Changes in blood tests: SR (Lowering Reaction), CRP, CCP / ACPA

Psoriatic arthritis

  • By known skin psoriasis
  • Finger's outer joint (DIP) in the case of nail psoriasis
  • Often major joint swelling («fluid» in joints)
  • Blood tests with slightly increased CRP and SR (Lowering reaction)

Gout

  • Incidentally very active arthritis ("podagra" fo the big toe)
  • Most often among men
  • Some have known, renal impairment
  • Blood test clearly shows elevated uric acid
  • Microscopic joint fluid examination shows uric acid crystals

Casium pyrophosphate crystals, (Chondrocalcinose)

  • X-ray shows small calcium deposits in articular cartilage
  • Microscopy of joint fluid shows typical crystals

Infection

  • Most often a single joint area
  • More pronounced redness, heat and strong pain
  • Blood tests show increased CRP and ESR
  • Upon examination of joint fluid, bacteria are detected

Alkaptonuria (Ochronose)

Sarcoidosis

  • May cause swollen joints, especially in fingers

Treatment of osteoarthritis

  • Exercise therapy (after physiotherapist instruction)
  • Change your lifestyle (daily activity, weight reduction)
  • Medications that reduce symptoms (with little or moderate effect) should be used with caution (side effects over time)
    • Paracetamol (Paracet, Pinex, Pamol and others) is the first choice
    • NSAIDs (Ibux, Brufen, Naproxen, Diclofenac and others)
    • Cortisone injection in some cases
  • Statin treatment for high cholesterol may have a certain attenuating effect (shown for knee osteoarthritis)
  • The overtrained exercise is a training break / change of activity applicable
  • Operation
    • Hips and / or knee prostheses

Osteoarthritis and diet

Osteoarthritis (osteoarthritis) is characterized by "calcifications" in the joints. However, there is no increased calcium in the blood or other organs.

Literature

EULAR recommendations

Guidelines, criteria and various links

EULAR: 

-Kloppenburg M, 2018 (Treatment of Osteoarthritis of the Hand)

-Orthoff AK, R, 2018 (Physical activity)

-Zhang W, 2010(Diagnosis of knee osteoarthritis)

- EMEUNET

ACR:

-Hochberg MC, 2012 (Treatment of osteoarthritis of the hands, hips and knees;)


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