Osteoarthritis.

A degenerative disorder of the body’s joints characterised by the progressive erosion of joint cartilage and a repair reaction that causes deformity and pain. Pain is often the main manifestation.

Osteoarthritis is one of the main causes of physical disability in the general population and entails a serious change in quality of life, as well as significant use of health resources.

Description

Age is the most direct and significant individual risk factor, as osteoarthritis affects 80% of people over 75 and increases in all joints with age.

Obesity and being overweight are other major risk factors for the joint overload that it entails.

Osteoarthritis in the hands and knees is the form most associated with genetic factors (if first degree family members have it there is greater risk, especially in women).

The changes observed in x-rays do not always relate to the symptoms (pain) or disability.

Symptoms

The major clinical symptoms are found in the hips, spine, knees and hands. As well as pain, it leads to very characteristic bone crepitus (grinding) and thicker joints also show deformity due to the aforementioned bone proliferation. There may also be inflammation and the presence of abundant synovial fluid if there is joint failure, sometimes spontaneous or caused by exercise that is more intense than usual.

How is affected by the condition?

It occurs in older people, aged 50 years and older. The time it appears depends on different factors including use of the joint (more frequent in elite athletes) and initial anatomy. For example, some types of leg shape, although they may be considered normal, predispose to osteoarthritis more than others.

Diagnosis

A medical interview and physical examination indicate the diagnosis with a fair degree of certainty. A bone x-ray and examination of joint fluid (synovial) are also important. A CAT scan and NMR can also play a diagnostic role.

Typical treatment

Weight loss, appropriate exercises.

Pharmacological treatment is aimed at reducing pain and inflammation.

It is sometimes treated surgically to correct deformities or to implant prostheses (hip, knee or other joints).

In very advanced cases, appropriate use of a stick or walker.

The efficacy of nutritional supplements is controversial.

Typical tests

Medical interview, x-rays, CAT and NMR.

Prevention

Walking or using joints to the extent permitted by the pain allows joint function to be maintained and prevents the muscular atrophy that always accompanies excessive rest.