Osteoarthritis is a joint disease caused by the destruction of articular cartilage followed by changes in its component structures and joint functional impotence. The disease can affect any joint, the main forms of osteoarthritis being represented by: hip osteoarthritis (at the hip joint), gonarthrosis (affects the knees), spondylarthrosis (affects the spine), osteoarthritis of the shoulder and proximal and distal interphalangeal joints of the fingers.
What is osteoarthritis?
Osteoarthritis is a joint disease caused by the destruction of articular cartilage followed by changes in its component structures and joint functional impotence. The disease can affect any joint, the main forms of osteoarthritis being represented by: hip osteoarthritis (at the hip joint), gonarthrosis (affects the knees), spondylarthrosis (affects the spine), osteoarthritis of the shoulder and proximal and distal interphalangeal joints of the fingers.
Why does osteoarthritis occur?
The most common risk factors for osteoarthritis are:
- Inheritance;
- Gender: Females are more likely to be affected than males;
- Endocrine pathologies (hypothyroidism);
- Metabolic disorders (diabetes);
- Obesity;
- Joint overload;
- Professional or sports joint injuries.
Osteoarthritis occurs as a result of an imbalance between the processes of formation and destruction of cartilage due to the decrease in the number of chondrocytes (cells that are part of cartilage) and the destruction of collagen and proteoglycans due to the activity of certain enzymes. This imbalance can cause joint pain due to the formation of cartilage deformities between the joint surfaces, lack of damping of the movements and remodeling of the bone structures.
What are the symptoms of osteoarthritis?
The cardinal symptom in all types of osteoarthritis is arthralgia (joint pain) which can be:
- Mechanical type with disappearance in resting conditions;
- Accentuated in humid conditions and low ambient temperature.
Along with joint pain, osteoarthritis (limitation of active and passive movements of the affected joints) may be present in osteoarthritis, especially in the morning or after a long rest. Swelling of the joint (high volume joint), its visible deformations and the presence of cracks (cracks) when mobilizing the limb are common manifestations in patients with osteoarthritis.
Diagnosis of the disease
The diagnosis of osteoarthritis is established based on the anamnesis, the physical examination of the patient, the imaging and laboratory methods represented by:
- Radiography that allows the observation of a narrowing at the level of the interarticular spaces;
- Joint ultrasound and periarticular musculoskeletal ultrasound for examination of nearby soft tissues;
- Nuclear magnetic resonance allows obtaining detailed images of bone structures and soft tissues that make up the affected joint;
- Arthroscopy invasive method of diagnosis and treatment of osteoarthritis;
- Paraclinical laboratory investigations for the determination of rheumatoid factor, tumor markers and cytological and bacteriological analysis of synovial fluid extracted by joint puncture.
Osteoarthritis treatment
The treatment of osteoarthritis is symptomatic and aims to relieve pain, increase joint mobility and regain their functions by improving the patient’s quality of life.
Physical therapy tones the periarticular muscles, increases flexibility and reduces the pain syndrome through isotonic, isokinetic and postural exercises.
Occupational therapy is a method of treatment that involves modifying the way of performing physical activities to reduce the overload of the affected joints.
Drug therapy involves the administration of analgesics and non-steroidal anti-inflammatory drugs to reduce the painful discomfort of the patient with osteoarthritis.
Surgery involves the use of joint corticosteroid infiltrates to reduce pain, with hyaluronic acid to lubricate joint surfaces and osteotomy to realign intra-articular bone surfaces and regain functionality in the affected joint. The hip and knee prosthesis is used in the advanced stages of the disease and involves the replacement of joint structures with artificial devices to restore motor function in the affected limb.
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