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