Osteoarthritis

Dr Gulraj Matharu  

 = an extremely common degenerative joint disorder

  N.B. OA is NON-INFLAMMATORY, unlike Rheumatoid arthritis (RA) which is an    INFLAMMATORY condition

  Pathology: There is progressive loss of the articular cartilage + new bone formation (see classic OA x-ray features below)

  OA classification:

Primary - no clear underlying cause

                 More common in women and with increasing age

Secondary - there is a pre-existing joint abnormality

                     This abnormality can be either:

1.       Congenital: e.g. developmental dysplasia of the hip, Perthes disease

2.       Acquired: e.g. fractures, joint infection (septic arthritis), RA

    Joint distribution:

Can potentially affect any joint

Weight-bearing joints most commonly affected- HIP, KNEE

Also affected- hands (1 ^st carpometacarpal joint), distal interphalangeal joint (DIP) and proximal interphalangeal joint (PIP) of the fingers, wrist, spine.

  Symptoms:   

  1. Pain

Main presenting complaint

Classically: asymmetrical joint pain progressively worsening over a number of years

As disease progresses can get night pain disturbing sleep

Pain worse with movement/exercise and relieved by rest

  N.B. pain may be referred to joint below, so hip pain can be referred to the knee

  2. Stiffness

Occurs after resting, therefore stiffness worse in morning but improves as day progresses

Remember early morning stiffness is classically a feature of RA and its duration is a useful marker of RA disease activity

  3. Weakness