Article Revisions
Articular cartilage is the tissue located at the end of bones. It can deteriorate over time. This causes a common condition called osteoarthritis. It becomes worse over time. It can be debilitating.
Normally, cartilage is the shock absorber in a joint. It absorbs energy from jarring movement, protecting the bone and other tissue in the area. Cartilage is naturally an exceedingly slippery material. It helps the joint glide smoothly. When the cartilage begins to show wear and tear, the lining of the joint becomes inflamed and painful. This makes the joint stiff.
Joints Affected by Osteoarthritis |
Osteoarthritis is an extremely common ailment of aging. In fact, it’s the most common joint condition throughout the world. Researchers believe that there are more than 20 million people with osteoarthritis in the US alone. More than half of all people over the age of 65 have arthritis in at least one joint. Researchers think that nearly everyone over the age of 75 has some degree of osteoarthritis. If you’ve had an injury to a joint, you may develop osteoarthritis at a younger age.
What are the risk factors for osteoarthritis?
What are the symptoms of osteoarthritis?
How is osteoarthritis diagnosed?
What are the treatments for osteoarthritis?
Are there screening tests for osteoarthritis?
How can I reduce my risk of osteoarthritis?
What questions should I ask my doctor?
What is it like to live with osteoarthritis?
Articular cartilage is the tissue located at the end of bones. It can deteriorate over time. This causes a common condition called osteoarthritis. It becomes worse over time. It can be debilitating.
Normally, cartilage is the shock absorber in a joint. It absorbs energy from jarring movement, protecting the bone and other tissue in the area. Cartilage is naturally an exceedingly slippery material. It helps the joint glide smoothly. When the cartilage begins to show wear and tear, the lining of the joint becomes inflamed and painful. This makes the joint stiff.
Joints Affected by Osteoarthritis |
Osteoarthritis is an extremely common ailment of aging. In fact, it’s the most common joint condition throughout the world. Researchers believe that there are more than 20 million people with osteoarthritis in the US alone. More than half of all people over the age of 65 have arthritis in at least one joint. Researchers think that nearly everyone over the age of 75 has some degree of osteoarthritis. If you’ve had an injury to a joint, you may develop osteoarthritis at a younger age.
What are the risk factors for osteoarthritis?
What are the symptoms of osteoarthritis?
How is osteoarthritis diagnosed?
What are the treatments for osteoarthritis?
Are there screening tests for osteoarthritis?
How can I reduce my risk of osteoarthritis?
What questions should I ask my doctor?
What is it like to live with osteoarthritis?
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil Textbook of Medicine. 21st ed. W.B. Saunders Company; 2000.
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop osteoarthritis with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing osteoarthritis. If you have a number of risk factors, ask yourdoctor what you can do to reduce your risk.
Specific Lifestyle Factor
- Weakness of the thigh muscles may increase your risk of osteoarthritis of the knee. Exercises that strengthen the thigh muscles may provide some protection against osteoarthritis.
Medical Condition
You have an increased risk of developing osteoarthritis if you have or have had:
- Past injury to a joint
- Previous surgery to the joint
- History of infection in a joint
- Congenital defect or weakness in a joint
- Acromegaly (a pituitary disorder)
- Paget’s disease of bone
- Hemochromatosis (iron overload disease)
- Gout or pseudogout
- Bleeding into the joint (as occurs with hemophilia)
Age
- 50% of people over the age of 65 have arthritis in at least one joint
- Over 80% of people over the age of 75 have arthritis in at least one joint
- Not all of these people will have significant symptoms
Gender
- Under age 45, more men than women have osteoarthritis
- Over age 55, more women than men have osteoarthritis
Genetic Factors
The tendency to develop osteoarthritis frequently runs in families.
Ethnic Background
Risk factors for developing osteoarthritis in specific joints are different for different ethnic backgrounds. For example:
- Caucasians have a higher overall risk of developing osteoarthritis than Asians.
- Osteoarthritis of the hip is less common in Chinese, Jamaican, and South African people of color, and Asian Indians; hip and knee osteoarthritis is more common among the Japanese.
- African-American women have more osteoarthritis of the knee and less osteoarthritis of the hand than do Caucasian women in the US.
Other
You are more likely to develop osteoarthritis if you:
- Are overweight
- Work at a job or participate intensely in an athletic pursuit that requires a lot of lifting, squatting,or repetitive joint use
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
Symptoms of osteoarthritis include the following:
- Pain in the joint
- Most commonly affected joints are those of the knee, hip, hand, or spine
- Pain usually increases when the joint is used or stressed
- Pain is usually decreased by resting the joint
- May be described as a dull, achy pain or a sharper, stabbing sensation
- Stiffness
- Stiffness can make everyday activities difficult, such as leaning down to pick something up, putting on shoes, opening a jar, walking, or climbing stairs.
- Stiffness occurs first thing in the morning is common, usually lasting under 30 minutes after you resume activity.
- Stiffness after any period of inactivity is common (such as after sitting still for a couple of hours in a movie theater or on an airplane).
- Stiffness decreases your range of motion, so that you can’t bend or unbend a joint as far as you normally could.
- You may have a feeling of instability in the joint. For example, your knee may feel as if it is going to buckle underneath you.
- You may feel or hear a grating or creaking sound when you bend or unbend your joint.
- Your joint may develop an abnormal appearance:
- It may appear inflamed, red, swollen.
- It may appear misaligned or misshapen.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil Textbook of Medicine. 21st ed. W.B. Saunders Company; 2000.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
Osteoarthritis is usually diagnosed after your doctor has taken a careful history of your symptoms. A physical exam will be done. There are no definitive lab blood tests to make an absolute diagnosis of osteoarthritis. Certain tests, specifically x-rays of the joint, may confirm your doctor’s impression that you have developed osteoarthritis.
X-ray examination of an affected joint—A joint with osteoarthritis will have lost some of the normal space that exists between the bones. This space is called the joint space. This joint space is made up of articular cartilage, which becomes thin. There may be tiny new bits of bone (bone spurs) visible at the end of the bones. Other signs of joint and bone deterioration may also be present. X-rays , however, may not show very much in the earlier stages of osteoarthritis, even when you are clearly experiencing symptoms.
Arthrocentesis—Using a thin needle, your doctor may remove a small amount of joint fluid from an affected joint. The fluid can be examined in a lab to make sure that no other disorder is causing your symptoms (such as rheumatoid arthritis , gout , infection).
Blood tests—Blood tests may be done to make sure that no other disorder is responsible for your symptoms (such as rheumatoid arthritis or other autoimmune diseases that include forms of arthritis). Researchers are also looking at whether the presence of certain substances in the blood might indicate osteoarthritis and help predict the severity of the condition. These substances include breakdown products of hyaluronic acid (a substance that lubricates joints) and a liver product called C-reactive protein.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil Textbook of Medicine. 21st ed. W.B. Saunders Company; 2000.
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
There are no real methods for preventing the development of osteoarthritis. However, following certain preventive measures may slow its progression. Such measures include:
Maintain an Appropriate Weight
Keep your weight in an appropriate range for your age, height, and body type. Carrying excess body weight can put increased stress on your bones and joints. By maintaining a healthful weight, you can reduce the stress on your body.
Avoid Certain Activities
Although exercise is good for your body, you may want to avoid activities that might injure your joints or that require intense, repetitive joint motion, or repetitive stress on “at risk” joints.
Eat a Balanced Diet
Eat a diet rich in calcium and vitamin D . This will help build strong bones.
Begin an Exercise Program
Participating in a safe exercise program will strengthen your muscles, which will help support and stabilize your joints. And these muscles help to absorb some of the energy, or shock, delivered to the limb.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil Textbook of Medicine. 21st ed. W.B. Saunders Company; 2000.
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
American College of Rheumatology
Address:
PO Box 7669
Atlanta, GA 30357-0669
Phone:
1-404-633-3777
1-800-568-4045
Internet Address:
http://www.rheumatology.org
Description of services provided:
This site has fact sheets about various arthritic conditions, as well as information on recent research and upcoming conferences. There are also fact sheets offering descriptions of the roles played by various healthcare team members. You can access a listing of members by geographic area.
Arthritis Foundation
Address:
1330 West Peachtree St.
Atlanta, GA 30309
Phone:
1-800-568-4045
Internet Address:
http://www.arthritis.org
Description of services provided:
Look here for a wealth of information about types of arthritis, information on various treatments, support group information, and lots of tips for living with arthritis. You can read the latest issue of the organization's magazine Arthritis Todayor join a group called “Connect and Control,” which will help devise an exercise plan for you. You can read message boards and essays from people meeting the challenges of living with arthritis. Details of recent research studies are available. Link to the local office of the Arthritis Foundation in your community to get referrals to specialists.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Address:
1 AMS Circle
Bethesda, MD 20892
Phone:
1-301-495-4484
Email:
niamsinfo@mail.nih.gov
Internet Address:
http://www.niams.nih.gov
Description of services provided:
This website offers detailed information about osteoarthritis, as well as other types of arthritis and rheumatic diseases, and skin and muscle disorders; news releases and recent research findings; information on research initiatives and on studies that are accepting patients as subjects.
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
Screening Guidelines
There are no screening guidelines or tests available for early diagnosis of osteoarthritis. Patients are usually diagnosed when they begin to notice symptoms and bring this to the attention of their doctor.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Cecil Textbook of Medicine. 21st ed. W.B. Saunders Company; 2000.
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
Each person has a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with osteoarthritis. By talking openly and regularly with your doctor, you can take an active role in your care.
General Tips for Gathering Information
Here are some tips that will make it easier for you to talk to your doctor:
- Bring someone else with you. It helps to have another person hear what is said and think of questions to ask.
- Write out your questions ahead of time, so you don't forget them.
- Write down the answers you get, and make sure you understand what you are hearing. Ask for clarification, if necessary.
- Don't be afraid to ask your questions or ask where you can find more information about what you are discussing. You have a right to know.
Specific Questions to Ask Your Doctor
About Osteoarthritis
- Do my symptoms suggest that I have osteoarthritis?
- Are there any other joint diseases that this could represent?
- Do you feel that I need any other diagnostic tests?
About Treatment Options
- What lifestyle changes should I institute?
- What comfort measures (such as heat, cold, brace, etc.) might be helpful?
- Should I consider other treatments, such as corticosteroid injections or hyaluronic acid injections?
- Should I consider any surgical procedures?
- What is likely to happen without treatment?
- What medications can I take to reduce pain and improve my ability to function normally?
- What are the benefits/side effects of these medications?
- Will these medications interact with other medications, over-the-counter products, or dietary or herbal supplements that I am already taking?
- Are there any alternative or complementary therapies that will help me?
About Lifestyle Changes
- Should I lose weight?
- What is a healthy target weight that I should work to maintain?
- Can you recommend a registered dietitian who can help me learn about healthful eating?
- Should I be taking vitamin C and vitamin D supplements?
- What kinds of exercise should I do to increase my muscle strength?
- Are there exercises or athletic activities that will overly stress my joints, and which I should therefore avoid?
- Could my occupation be contributing to my joint disease and symptoms?
About Outlook
- What is the usual progression of osteoarthritis?
- How can I slow or halt the progression of osteoarthritis?
- Do I have to give up or change any of my activities now or in the future?
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Conn’s Current Therapy. 54th ed. W.B. Saunders Company; 2002.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician. 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
