Osteoarthritis:

A degenerative disease of joints resulting from wear of the articular cartilage , which may lead to secondary changes in the underlying bone.

Etiology:

Primary: Unknown

Secondary:

·         Trauma

·         Occupational overuse of a joint

·         Metabolic diseases:

·         Hyperparathyroidism

·         Ochronosis alcaptonuria

·         Neurological disease:

·         Tabes dorsalis

·         Obesity

Pathophysiology:

·         Degeneration of cartilage

·         Hypertrophy of the bone

·         Thickening of synovial membrane

·         Reduction of the joint cavity (not obliterated)

Clinical features:

·         Onset : Insidious (slow)

·         Morning stiffness not more than 15 min

·         Pain:

Worse on activity

Relieved by rest

·         Asymmetrical joint involvement

·         Limited range of movement

·         Distal interphalangeal joint involvement as compared to rheumatoid arthritis

·         Number of joint involve is less as compared to rheumatoid arthritis

Investigations:

·         ESR will be normal because of no inflammation

·         X – ray:

·         Narrowing of joint space due to loss of cartilage

·         Formation of osteophytes at the margin of the joints

·         Cyst formation

Management:

General measures

·         Weight reduction

·         Rest

·         Joint protection

Physical therapy:

·         Heat therapy

·         Hydrotherapy

·         Proper exercises

Drug treatment:

·         Acetaminophen (Ponston)

·         NSAIDs

·         Inj. Triamcinolone

Surgery:

Joint replacement