DEGENERATIVE JOINT DISEASE = OSTEOARTHRITIS

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DEGENERATIVE JOINT DISEASE OSTEOARTHRITIS
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DEGENERATIVE JOINT DISEASE
Degenerative joint disease is chracterized by 1.
pain 2. stiffness 3. 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.
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• 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.

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• 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

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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
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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

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OSTEOARTHRITIS- spine

• OA affects
• weight-bearing joints(knee,hip),
• interphalangeal joints of the hands
• ( PIP-Bouchard s nodes,DIP joints-Heberdens
  nodes) and feet
• Spine
• (spondylosis and spondylarthritis)

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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_

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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

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Osteoarthritis-surgical treatment
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Osteoarthritis-surgical treatment