OA is both overdiagnosed and trivialized; it is frequently overtreated or undertreated.The functional impact of OA on the quality of life, especially the elderly patients, is often ignored.ClassificationOsteoarthritis is classified into two classifications, yet the distinction between the two of them is always unclear.Primary or idiopathic OA has no prior event or disease related to it.Secondary OA results from previous joint injury or inflammatory disease.PathophysiologyOsteoarthritis may be thought of as the result of many factors that, when combined, predispose the patient to the disease.Normal Joint vs Osteoarthritic JointMechanical injury. OA starts from an injury of the articular cartilage, subchondral bone, and synovium.Chondrocyte response. Factors that initiate chondrocyte response include previous joint damage, genetic and hormonal factors, and others.Cytokines. After the chondrocyte response, the release of cytokines occurs.Stimulation of enzymes. Proteolytic enzymes, metalloproteases, and collagenase are stimulated, produced, and, released.Damage. The resulting damage predisposes to damage further as the chondrocyte is triggered to respond again.Osteoarthritis by OsmosisCheck out this awesome pathophysiology and easy to understand video by Osmosis. Support them to make more videos like this via Patreon.
Statistics and EpidemiologyOsteoarthritis often begins with the third decade of life and peaks between the fifth and the sixthdecades.By 40 years of age, 90% of the population has degenerative joint changes in their weight-bearing joints.Prevalence of OA is between 50% and 80% in the elderly.Increasing age directly relates to the degenerative process in the joint.CausesUnderstanding of osteoarthritis has been greatly expanded beyond what was previously thoughtof as simply “wear and tear” related to aging and the causes include:Increased age. Most elderly people experience osteoarthritis because the ability of the articular cartilage to resist microfracture with repetitive loads diminishes with age.Obesity. Obese people easily wear out their weight-bearing joints because of their increased weight.Previous joint damage. Having a previous joint damage predisposes the patient to secondary OA.Repetitive use. Repetitive use due to occupational or recreational factors also causes OA.Clinical ManifestationsOsteoarthritis has primary signs and symptoms, and that includes:Comparing Osteoarthritis and Rheumatoid ArthritisPain. An inflamed synovium causes the pain, stretching of the joint capsule or ligaments, irritation of the nerve endings in periosteum over osteophytes, trabecular microfracture, intraosseous, hypertension, bursitis, tendinitis, and muscle spasm.Stiffness. Stiffness, which is mostly experienced in the morning or upon awakening, usually lastsless than 30 minutes and decreases with movement.
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