DEGENERATIVE JOINT DISEASE

=OSTEOARTHRITIS

DEGENERATIVE JOINT DISEASE

Degenerative joint disease is chracterized by:1. pain2. stiffness3. loss of mobility

due to degeneration of synovial joints

Among the most frequent and symptomatic medical problems

in middle-aged and older people

The most common cause of long therm disability in most

populations

It affects men and women of all etnic groups in all geographic

locations.

Degenerative joint disease = osteoarthritis = = degenerative arthritis reffers to:

1. progressive loss of articular cartilage 2.accompanied by inadequate repair of articular

cartilage 3. remodeling of subchondral bone 4. formation of osteophytes.

It can affect any synovial joint

The food, knee, hip, spine and hand joints are affected most often.

The strong association exists between joint degeneration and age.

1. CARTILAGE CHANGES • localised fibrillation or disruption of tehe most

superficial layers of cartilage.• the surface become roughened and irregular, fibrillation

goes deeper, it reaches subchondral bone• decrease of cartilage surface• enzymatic degradation of the matrix-decrease of

cartilage volume

2. BONE CHANGES• alterations of the subchondral bone density: formation

of cyst-like bone cavities• increase of bone density - completely lost of cartilage

3. OSTEOPHYTES• fibrous, cartilagineous and bony prominences develop

around the periphery of the joints

4. SECONDARY CHANGES• in the synovium, capsules, ligaments and musculs

moderate inflammatory reaction

CLINICAL MANIFESTATIONS OF OA

1. pain activity associated, soon after the joint is used in more advanced stages the pain becomes constant and awakened patient from sleep

2. joint stiffness

3. loss of motion, grinding, osteophytes formation

VARIOUS SYMPTOMS FROM:

• occasional joint stiffness

• intermittent aching associated with activity

• permanent and severe restriction of motion

• with constant deep pain

• crippling deformity and joint instability

OSTEOARTHRITIS- spine

OA affects

• weight-bearing joints(knee,hip),

• interphalangeal joints of the hands

( PIP-Bouchard ´s nodes,DIP joints-Heberden´s nodes) and feet

• Spine

(spondylosis and spondylarthritis)

INVESTIGATION

• X-rays may show:– Loss of joint space resulting from cartilage

damage– Osteophytosis(forrmation of new bone)– Altered bone contour– Subchondral sclerosis(increase bone

density),cystic formation– Soft tissue swelling and periarticular

calcification_

TREATMENT

• Primarily involves pain relief, initially with simple analgesics

• NSAIDs may be added if these are requied, Appropriate exercises

• Intra-articular steroid injections are useful if there are signs of inflammation

• Surgery –when the pain is intractable and severe limitation of mobility is present

Osteoarthritis-surgical treatment

Osteoarthritis-surgical treatment