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Orthopedics => Osteoarthritis
Osteoarthritis
INTRODUCTION
Osteoarthritis (or osteoarthrosis), inflammation of the joints between bones, most often as a result of wear and tear over the years. The illness is therefore most commonly found in those over the age of 55. It may also be caused by a direct injury to a joint. It affects millions of people worldwide. The joints most commonly affected by osteoarthritis are the knees, hips, and those in the neck and back.
CAUSES AND SYMPTOMS
Normally, the ends of the bones in a joint are protected by cartilage, which is smooth, elastic connective tissue (with no blood supply) that cushions the joint and allows for ease of movement. In osteoarthritis, the wear and tear of using the joint for years eventually causes the cartilage to deteriorate, changing its surface from smooth to rough. As the cartilage deteriorates, the ends of the bones begin to rub together, causing swelling and eventually resulting in the lumpy growth of bone along the sides of the joint.
These changes cause the typical symptoms of osteoarthritis: pain on and after using the joint; swelling and a gradual loss of flexibility in a joint; discomfort in a joint whenever the weather becomes damper; and, where the fingers are affected, bony lumps on the finger joints. These lumps, called Heberden's nodes when they occur on the end joint of the finger, and Bouchard's nodes on the middle joint of the finger, are ten times more common in women than in men.
DIAGNOSIS AND TREATMENT
Osteoarthritis is diagnosed by observing the symptoms, by a physical examination, and, if necessary, with the help of X-rays, which may detect a narrowing of the space between joints, and bony projections on the edges of bones. Physiotherapy to prevent further stiffening, and sensible exercise, such as swimming, may help. Losing weight if obese and maintaining good posture can also help ease the pressure on joints. A walking stick is often needed for hip problems.
To ease the pain and inflammation, aspirin or other anti-inflammatory drugs, such as ibuprofen, are the medicines of choice. In more severe cases, hydrocortisone may be injected into a joint to help the inflammation. This treatment is most often carried out on a joint that bears weight, such as the ankle or knee. In cases where the deterioration of a joint is extensive, however, surgery may be done to install a plastic or steel replacement. This procedure, known as replacement arthroplasty, is most often performed on hip joints. However, replacements are also performed on knee and finger joints.
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