Osteoarthritis

Dr Craig Hacking and R Bronson et al.

Osteoarthritis (OA), or degenerative joint disease (DJD), is the most common form of arthritis.

Given osteoarthritis is not primarily an inflammatory process, as might be suggested by the suffix "itis", some authors prefer the term osteoarthrosis instead. 

Primary osteoarthritis is the less common variant and is characterized by the absence of an antecedent insult. There is a strong genetic component 5 with the disease primarily affecting middle-aged women.

Secondary osteoarthritis is more common, caused by abnormal mechanical forces (e.g. occupational stress, obesity) or by a previous joint insult (e.g. trauma, rheumatoid arthritis).

Key radiographic features are joint space narrowing, sclerosis, and osteophytosis. If all three of these findings are not present, another diagnosis should be considered.

Joint space narrowing

  • characteristically asymmetric
  • least specific: present in many other pathological processes

Sclerosis

  • sclerotic changes occur at joint margins
  • frequently seen unless severe osteoporosis is present

Osteophytosis

  • i.e. development of osteophytes
  • common DJD finding
  • will also be diminished in the setting of osteoporosis
  • some osteophytes carry eponymous names, as discussed below

It affects the distal interphalangeal joints (Heberden nodes), the proximal interphalangeal joints (Bouchard nodes), (mnemonic H-D, B-P) and the base of the thumb in a bilaterally symmetric fashion. If it is not bilaterally symmetric, the diagnosis of primary osteoarthritis should be questioned.

Joint erosions

  • several joints may exhibit degenerative erosions
    • temporomandibular joint
    • acromioclavicular joint
    • sacroiliac joints
    • symphysis pubis

Subchondral cyst 

Arthritides
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Article information

rID: 1794
Tag: rewrite
Synonyms or Alternate Spellings:
  • OA
  • Osteoarthritis (OA)
  • Osteoarthrosis
  • Degenerative joint disease (DJD)
  • Degenerative joint disease
  • Degenerative disease of the joints

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Cases and figures

  • Figure 1: distribution in the hand
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  • Case 1: right hip
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  • Case 1: post-THJR
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  • Case 2: involving hands
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  • Case 3: involving knees
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  • Supraspinatus tear
    Case 4: AC joint osteoarthritis
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  • Case 5: involving hip
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  • Case 6: hip osteoarthritis post traumatic
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  • Case 7: elbow
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  • Case 8: knees
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