Osteoarthritis

Author(s):  
Michael Doherty

Osteoarthritis (OA) is a disorder of synovial joints and is characterized by the combination of focal hyaline cartilage loss and accompanying subchondral bone remodelling and marginal new bone formation (osteophyte). It has genetic, constitutional, and environmental risk factors and presents a spectrum of clinical phenotypes and outcomes. OA commonly affects just one region (e.g. knee OA, hip OA). However, multiple hand interphalangeal joint OA, usually accompanied by posterolateral firm swellings (nodes), is a marker for a tendency towards polyarticular ‘generalized nodal OA’.

2009 ◽  
Vol 18 (1) ◽  
Author(s):  
Barbara Slatkowsky-Christensen ◽  
Margreth Grotle

Osteoarthritis (OA) is a complex process affecting many different joint areas in the body. The joints most commonly affected are the knees, hips, and hands. From a patho-physiological point of view, some features are crucial for the diagnosis, such as cartilage fibrillation and thinning, subchondral sclerosis and the presence of osteophytes. The currently most widely used definitions of OA include pathogenetic features (mechanical and biological events), morphologic features (changes in articular cartilage and subchondral bone) as well as clinical features (joint pain, stiffness, tenderness, limitation of movement, crepitus and occasionally inflammation/effusion).<br />The features that until now have been used for diagnosis and classification are based on radiographic and/or clinical descriptions. From a clinical perspective, OA is the most prevalent rheumatic joint disorder, causing pain and stiffness of the joints and for the individual impaired function and health status. For epidemiological descriptions of prevalence and incidence of OA, radiographic criteria are the most reliable and commonly used. Definitions of radiographic OA include descriptions of cartilage thinning (such as joint space narrowing), subchondral bone involvement (sclerosis) and/or the presence and grading of osteophytes. Although there are geographical variations in the occurrence of OA of different joint areas, OA is seen in all populations studied. The prevalence and incidence estimates show a vide variation, however. Still the epidemiological studies of OA are hampered by a number of factors including different definitions of the disorder, different subsets of disease, and low degree of correlation between different definitions (radiographic vs clinical). Several highly suggested risk factors have been identified for knee OA. Several of these may be important targets for intervention or prevention, such as physical activity, body mass index, nutritional constituents and quadriceps strength. There is a need for prospective studies evaluating risk factors in hip and hand OA. Although there are problems in studying OA epidemiologically, the available data have shown that OA is an extremely common and disabling disorder. Through a further development of both epidemiological and other methods of OA research, this area can continue to be exciting and rapidly developing.


2021 ◽  
Vol 27 (1) ◽  
pp. 112-120
Author(s):  
V.B. Novakov ◽  
◽  
O.N. Novakova ◽  
M.I. Churnosov ◽  
◽  
...  

Introduction Osteoarthritis (OA) is a heterogenic group of disorders of different etiology with similar biological, morphological and clinical manifestations and outcomes. OA is now considered a disease of the whole joint, including alterations in the articular cartilage, subchondral bone, synovial membrane, ligaments, capsule and periarticular muscles. OA of the knee as the most commonly affected joint accounts for the great medical, medical, social and economic impact. Material and methods A literature review assessing Russian and foreign studies on molecular mechanisms of etiology and pathogenesis of knee OA identified a set of factors for which there was consistent evidence for their association with onset of knee OA. A search of studies published in Russian and in English for the last ten years was conducted using bibliographic databases, including PubMed, PubMedCentral, GoogleScholar, eLIBRARY. Search terms included 'knee osteoarthritis', 'etiology', 'pathogenesis', 'risk factors'. Results Review of the literature showed that patients with knee OA are characterized by changes in cartilage, subchondral bone, synovium, suggesting common mechanisms of joint degeneration during OA development. Osteoarthritis (OA) is multifactorial in origin and closely associated with a wide spectrum of local (previous injury, muscle weakness, knee malalignment, knee surgeries, abnormal mechanical loading, excessive high impact sports, occupational physical activities) and systemic risk factors (advanced age, female sex, height, greater body mass index and obesity, hormone status, family history, mineral bone density, vitamin D deficiency, ethnicity). The prevalence of the knee OA and patterns of joint involvement vary among different racial and ethnic groups. Conclusion The literature review allowed us to identify the molecular mechanisms of etiopathogenesis of knee OA and the major risk factors for the pathology.


2006 ◽  
Vol 53 (4) ◽  
pp. 11-15 ◽  
Author(s):  
S. Slavkovic ◽  
Z. Vukasinovic ◽  
N. Slavkovic ◽  
M. Apostolovic ◽  
S. Tomic

Authors present 420 hips with slipped capital epiphysis treated in the IOHB "Banjica", during the period between 1970 and 2005. Research includes the analysis of incidence, diagnostics and causes which contribute to the genesis of hip chondrofibrosis. Risk factors are shown, as well as the approach to eliminate them. 39 hips in which this complication occurred were individually analyzed. Every hip was separately studied with intent to determine the cause of the condition?s genesis, it?s evolution, treatment and it?s final functionality result. Synovia biopsy was performed in 7 cases, as well as the biopsy of the capsule, articular hyaline cartilage and subchondral bone of the femoral head, which enabled detailed description of both microscopic and macroscopic changes that follow this condition. Regardless of still hypothetical comprehension of the inception of chondrofibrosis, authors clearly state all the risky procedures during treatment that can contribute to the development of chondrofibrosis. The importance of early diagnostics and well-timed treatment are highlighted in this article, for they are crucial. Results of treated hip chondrofibrosis presented here give hope for the destiny of the ill joint, which was considered highly uncertain for a long time.


2016 ◽  
Vol 68 (10) ◽  
pp. 2456-2465 ◽  
Author(s):  
Janine Bleil ◽  
Rene Maier ◽  
Axel Hempfing ◽  
Joachim Sieper ◽  
Heiner Appel ◽  
...  

2021 ◽  
pp. jnnp-2020-325688
Author(s):  
Anna Karin Hedström ◽  
Jan Hillert ◽  
Tomas Olsson ◽  
Lars Alfredsson

ObjectiveIt has been debated whether the different clinical disease courses in multiple sclerosis (MS) are the consequence of different pathogenic mechanisms, with distinct risk factors, or if all MS clinical phenotypes are variations of similar underlying disease mechanisms. We aimed to study environmental risk factors and their interactions with human leucocyte antigen DRB1*15:01 with regards to relapsing-onset and progressive-onset MS.MethodsWe used two Swedish population-based case–control studies, including 7520 relapsing-onset cases, 540 progressive-onset cases and 11 386 controls matched by age, sex and residential area. Logistic regression was used to estimate ORs with 95% CIs for associations between the different MS phenotypes and a number of environmental and lifestyle factors. Interaction between the DRB1*15:01 allele and environmental risk factors was evaluated on the additive scale.ResultsAll environmental and lifestyle factors associated with risk of developing MS apply to both relapsing-onset and progressive-onset disease. Smoking, obesity and Epstein-Barr virus nuclear antigen-1 (EBNA-1) antibody levels were associated with increased risk of both MS phenotypes, whereas snuff use, alcohol consumption and sun exposure were associated with reduced risk. Additive interactions between DRB1*15:01 and smoking, obesity, EBNA-1 antibody levels and sun exposure, respectively, occurred to increase MS risk regardless of the clinical phenotype.InterpretationOur finding that the same environmental and lifestyle factors affect both relapsing-onset and progressive-onset MS supports the notion that the different clinical phenotypes share common underlying disease mechanisms.


2010 ◽  
Author(s):  
Thomas A. Wills ◽  
Pallav Pokhrel ◽  
Frederick X. Gibbons ◽  
James D. Sargent ◽  
Mike Stoolmiller

2012 ◽  
Author(s):  
M. Pugliatti ◽  
I. Casetta ◽  
J. Drulovic ◽  
E. Granieri ◽  
T. Holmøy ◽  
...  

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