Osteoarthritis

Osteoarthritis
Other namesArthrosis, osteoarthrosis, degenerative arthritis, degenerative joint disease
The formation of hard knobs at the middle finger joints (known as Bouchard's nodes) and at the farthest joints of the fingers (known as Heberden's nodes) is a common feature of osteoarthritis in the hands.
Pronunciation
  • /ˌɒstioʊɑːrˈθraɪtɪs/
SpecialtyRheumatology, orthopedics
SymptomsJoint pain, stiffness, joint swelling, decreased range of motion[1]
Usual onsetOver years[1]
CausesConnective tissue disease, previous joint injury, abnormal joint or limb development, inherited factors[1][2]
Risk factorsOverweight, legs of different lengths, job with high levels of joint stress[1][2]
Diagnostic methodBased on symptoms, supported by other testing[1]
TreatmentExercise, efforts to decrease joint stress, support groups, pain medications, joint replacement[1][2][3]
Frequency237 million / 3.3% (2015)[4]

Osteoarthritis is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone.[5][6] A form of arthritis, it is believed to be the fourth leading cause of disability in the world, with an estimated 240 million people worldwide having activity-limiting osteoarthritis.[7][8] The most common symptoms are joint pain and stiffness.[1] Usually the symptoms progress slowly over years.[1] Other symptoms may include joint swelling, decreased range of motion, and, when the back is affected, weakness or numbness of the arms and legs.[1] The most commonly involved joints are the two near the ends of the fingers and the joint at the base of the thumbs, the knee and hip joints, and the joints of the neck and lower back.[1] The symptoms can interfere with work and normal daily activities.[1] Unlike some other types of arthritis, only the joints, not internal organs, are affected.[1]

Possible causes include previous joint injury, abnormal joint or limb development, and inherited factors.[1][2] Risk is greater in those who are overweight, have legs of different lengths, or have jobs that result in high levels of joint stress.[1][2][9] Osteoarthritis is believed to be caused by mechanical stress on the joint and low grade inflammatory processes.[10] It develops as cartilage is lost and the underlying bone becomes affected.[1] As pain may make it difficult to exercise, muscle loss may occur.[2][11] Diagnosis is typically based on signs and symptoms, with medical imaging and other tests used to support or rule out other problems.[1] In contrast to rheumatoid arthritis, in osteoarthritis the joints do not become hot or red.[1]

Treatment includes exercise, decreasing joint stress such as by rest or use of a cane, support groups, and pain medications.[1][3] Weight loss may help in those who are overweight.[1] Pain medications may include paracetamol (acetaminophen) as well as NSAIDs such as naproxen or ibuprofen.[1] Long-term opioid use is not recommended due to lack of information on benefits as well as risks of addiction and other side effects.[1][3] Joint replacement surgery may be an option if there is ongoing disability despite other treatments.[2] More than 90% of hip and knee joint replacements are due to osteoarthritis. An artificial hip or knee joint typically lasts more than 20 years.[8]

Osteoarthritis is the most common form of arthritis, affecting about 237 million people or 3.3% of the world's population as of 2015.[4][12] It becomes more common as people age.[1] Among those over 60 years old, about 10% of males and 18% of females are affected.[2] Osteoarthritis is the cause of about 2% of years lived with disability.[12] Those with osteoarthritis of the hips or knees (the most commonly affected large joints) have a 20% increased risk of mortality, possibly due to reduced activity levels.[8]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v "Osteoarthritis". National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2015. Archived from the original on 18 May 2015. Retrieved 13 May 2015.
  2. ^ a b c d e f g h Glyn-Jones S, Palmer AJ, Agricola R, et al. (July 2015). "Osteoarthritis". Lancet. 386 (9991): 376–387. doi:10.1016/S0140-6736(14)60802-3. PMID 25748615. S2CID 208792655.
  3. ^ a b c McAlindon TE, Bannuru RR, Sullivan MC, et al. (March 2014). "OARSI guidelines for the non-surgical management of knee osteoarthritis". Osteoarthritis and Cartilage. 22 (3): 363–388. doi:10.1016/j.joca.2014.01.003. PMID 24462672.
  4. ^ a b GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  5. ^ Arden N, Blanco F, Cooper C, et al. (2015). Atlas of Osteoarthritis. Springer. p. 21. ISBN 978-1-910315-16-3. Archived from the original on 8 September 2017.
  6. ^ "A National Public Health Agenda for Osteoarthritis 2020" (PDF). U.S. Centers for Disease Control and Prevention (CDC). 27 July 2020.
  7. ^ Hunter DJ, Bierma-Zeinstra S (April 2019). "Osteoarthritis". Lancet. 393 (10182): 1745–1759. doi:10.1016/S0140-6736(19)30417-9. PMID 31034380.
  8. ^ a b c Katz JN, Arant KR, Loeser RF (9 February 2021). "Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review". JAMA. 325 (6): 568. doi:10.1001/jama.2020.22171. PMC 8225295. PMID 33560326.
  9. ^ Cite error: The named reference SBU2016 was invoked but never defined (see the help page).
  10. ^ Berenbaum F (January 2013). "Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!)". Osteoarthritis and Cartilage. 21 (1): 16–21. doi:10.1016/j.joca.2012.11.012. PMID 23194896.
  11. ^ Conaghan P (2014). "Osteoarthritis – Care and management in adults". Archived from the original (PDF) on 22 December 2015. Retrieved 21 October 2015.
  12. ^ a b March L, Smith EU, Hoy DG, et al. (June 2014). "Burden of disability due to musculoskeletal (MSK) disorders". Best Practice & Research. Clinical Rheumatology. 28 (3): 353–366. doi:10.1016/j.berh.2014.08.002. PMID 25481420.
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