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Osteoarthritis Affecting Joints Symptoms Risk Factors Diagnosis And Management

Osteoarthritis Affecting Joints Symptoms Risk Factors Diagnosis And Management

Posted By HealthcareOnTime Team Posted on 2022-01-21

With the birth of first great civilizations, progress from prehistory to antiquity emergence of 1st medical studies that replaced archaic conceptions involving gods for healing with more rational approach based on observation Osteoarthritis (OA) has been through all of these different chapters of mankind.

Osteoarthritis Affecting Joints Symptoms Risk Factors Diagnosis And Management

Often considered as the planet's oldest known disease, presence of Osteoarthritis has been documented in the skeletons of dinosaurs roughly around 5 to 7 crore years ago. It was frequently observed in numerous Egyptian mummies and in ancient skeletons from England. Unlike today, Osteoarthritis of the shoulders and spine were more OSTEOARTHRITIS common than the knee joints illustrating more of physical labor and less obesity a in the foregone time.

Osteoarthritis is the most common form of arthritis, more prevalent in elderly, also termed to be DIET a degenerative disease as it results in structural and functional failure of synovial joints. People suffering from this disease usually experience pain and stiffness in the affected joints. In contrast to other forms of arthritis, it does not affect other body parts like skin, lungs, eyes or blood vessels but remains confined to the hands, neck, knees, hips and lower back. This form of arthritis affects each person differently with severity varying from mild to unbearable pain.

Osteoarthritis Risk Factors :
Age: It is a major risk factor for Osteoarthritis. The biological changes occurring due to aging can contribute to cartilage thinning, weak muscle strength, and oxidative damage which may lead to Osteoarthritis.

Gender: Women have higher risks of developing Osteoarthritis than men and severity too is more. Besides this, during menopause, hormonal factors can also play an essential role in the development of Osteoarthritis.

Genetics: Children of parents suffering from Osteoarthritis are at greater risk for developing this types of arthritis than the children whose parents did not have Osteoarthritis.

Obesity: It is believed to be the most potent risk factor, especially in case of knee related Osteoarthritis, as 3 to 6 times of total body weight is transferred across the knee joint during walking.

Diet: Individuals with poor diet, with insufficient amounts of nutrition like vitamin D are more prone to Osteoarthritis, as their bones can become brittle or thin. Lack of other minerals like selenium, vitamin C and even vitamin k can cause bone related conditions. on joints at work is associated with Osteoarthritis. According to studies, knee related Osteoarthritis risk is more than double in males whose jobs required heavy weight lifting and squatting than to those who lacked these physical activities.

Osteoarthritis Affects Body Joints as below
Knee-A Hazard It is very common, mostly with old age or in obese individuals with intensity varying from moderate to unbearable. Osteoarthritis can affect main surface of the knee joint and cartilage under the knee cap (generally located inside or outside of the knee) but sometimes also in the shallow depression located at the back of the knee-joint.

Knee Osteoarthritis is not a localized disease but considered as a disease of the whole joint resulting from multiple factors including advanced age, genetics, knee misalignment, low bone density among others. Several studies have linked obesity to be the growing risk factor for knee osteoarthritis due to various reasons. In obese individuals, excess amount of adipose tissues results in increased synthesis of pro- inflammatory cytokines which may cause inflammation. Furthermore increase in weight, increases the pressure on knees by many folds while doing the daily activities

-Hip-Radiating Pain Hip joint is one of the largest weightbearing joints in humans following knees and is likely to be affected by Osteoarthritis. It affects both men and women equally, and may involve hips. Also seen to be more prevalent in individuals with hip problems like abnormal hip development in childhood.

Aging is assumed to cause hip Osteoarthritis mainly due to degenerative process along with genetics, joint morphology, weight and diet. Distribution of pain in the body is essential for accurate diagnosis of this condition. This type of Osteoarthritis leads to pain in the groin, thigh and knee which is acceptable but, pain radiating down to your knee (also known as radiating pain) makes its diagnosis difficult.

-Hand- Impairing the Hold Contrary to the common belief, this type of Osteoarthritis can also occur in younger individuals, impairing his/her ability to work. Osteoarthritis affecting hand can negatively impact wrist, fingertips, basilar joint connecting the thumb and wrist, and middle knuckles of the fingers. Cartilage present between these joints deteriorates, causing bones to rub together without a cushion, thereby causing inflammation and pain.

Factors such as age, biomechanical, BMI, genetics and tobacco smoking contributes as the risks for hand related Osteoarthritis. Moreover, hand injury and hypertension can also cause this disease. Pain, stiff wrists and fingers are the certain characteristic symptoms.

-Spinal Column- Affecting the Back Bone Facets are the only joint found in the spine, therefore, spinal arthritis means inflammation of the spinal facets. This type of condition generally occurs due to internal damage causing gradual deterioration of the cartilage present between the facets. This results in the friction and further joint injury leading to inflammation.

Stiffness and low back pain (which gets worst in the morning and during night while sleeping) are commonly experienced by the individuals

Causative Symptoms of Osteoarthritis
-Pain (during movement, may also occur with rest in advanced cases)
-Reduced function of the joint
-Swelling or deformity
-Joint instability

Tailoring the Physical Test
Tenderness over the joint
Bony enlargement
Restricted joint motion
Altered gait
Muscle atrophy/weakness
Joint effusion

Osteoarthritis Diagnosis and Management
Diagnosis of Osteoarthritis includes clinical examination by the physician, which is then confirmed by radiography. In advanced stages, Osteoarthritis is visible in plain radiographs showing bone abnormalities, whereas, advanced imaging techniques such as MRI or PET-CT Scan can be done to rule out other possibilities.

The approaches used for management varies according to the condition of the affected individual. However, aim remains the same which is mainly controlling the pain, improving the functioning of joint and altering the disease progress. Management includes:

Non-pharmacological Therapies Educating the patient about the condition, exercise to increase the aerobic capacity, weight loss (especially in obese individuals suffering from knee or hip Osteoarthritis), physical therapies (for joint movement, muscle strengthening and stretching) and supports like knee braces or orthotics sums up the non-pharmacological approach.

Pharmacological Therapies Various analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroids and topical treatments are available to ease the pain.

Surgery It is avoided till symptoms are manageable by non-pharmacological approaches or by the use of drugs. Exhausting pain and major limitation in movement of joints affecting the daily routine generally indicates surgery. Joint replacement therapy and osteotomy are a few options which can be adopted in certain severe cases.

What is Rheumatoid Arthritis ?
Joints are an essential part of the body. When afflicted by any malady they are refrained from performing their sole function. In Rheumatoid Arthritis, the immune system is unable to distinguish between self tissues and foreign bodies (like bacteria, virus or fungus). This mistaken recognition leads to an autoimmune response causing inflammation in synovial membrane that in turn leads to discomfort in movement of joints, erosive joint damage and cartilage, and bone destruction.

The onset of disease differs from patient to patient and the severity depends on the type and pattern of joints involved, as well as the number of affected joints. High incidence of RA is seen in people above 50 years of age and females are found to be 3-4 times more prone to rheumatoid arthritis than males.

Which all Joints gets affected in Rheumatoid Arthritis?
Different type of joint like ball and socket joint, hinge, saddle, plane and condyloid, function in specific kind of movements and cannot be replaced by one another. Therefore, a joint once deformed leaves the person unable to perform certain activities effectively. The joints of shoulder, elbow, wrist, finger joints, hips, knee, ankle and toe are commonly affected by Rheumatoid Arthritis. Usually, when Rheumatoid Arthritis proliferates, the first impact is seen on joints of hands and feet

Coping with Rheumatoid Arthritis
We are blessed to have flexible body which help us move, walk and perform the daily chores with ease. Our skeletal system possesses junctions, known as Joints that unites two or more bones and complete the bony frame of our body. However, these joints can get damaged to a great extent by degenerative diseases like Rheumatoid Arthritis (RA). Today, this inflammatory condition can be seen worldwide affecting 1% of the total population across the globe.

How to detect Rheumatoid Arthritis early?
Diagnosis can be done by evaluating medical history, clinical findings, serological assays (Blood test that looks for antibodies) and imaging tests. In patients suffering from Rheumatoid Arthritis, identification of the cause of incipient symptoms may help in better disease management by retarding Rheumatoid Arthritis spread and degradation of joints. Some tests that are efficient to evaluate the occurrence of Rheumatoid Arthritis are described below:

Serological and Synovial fluid Analysis Abnormal ranges of following parameters is the typical feature that indicate the possible presence of Rheumatoid Arthritis:
- Antibody screening reveals increasing levels of anti-rheumatoid antibodies and anti-citrullinated protein antibody in serum. It is present in almost 50 to 80% of individuals with RA.
-Erythrocyte Sedimentation Rate (ESR) indicate about the degree of inflammation. It usually remain elevated in people with Rheumatoid Arthritis.
-C-reactive protein (CRP) is also present in high amount in the sera of Rheumatoid Arthritis affected individuals. It is found to correlate with the severity and radiographic changes occurred due to Rheumatoid Arthritis.

Imaging With the use of imaging techniques, joint inflammation and bone deterioration can be observed in an early stage of Rheumatoid Arthritis. Some of them are enlisted below:
-Magnetic Resonance Imaging
Estimation of all risk factors and awareness for optimum diagnosis and treatment gives hope that this disease can be prevented in the near future

Is Obesity Linked to Arthritis?
According to World Health Organization (WHO), obesity across the globe has more than doubled over the past 30 years.' Obesity has been recognized since the time of Hippocrates who quoted 'Corpulence is not only a disease itself, but the harbingers of others which means a medical disorder responsible for multiple comorbidities.

A common but often underestimated condition- obesity, is defined as excessive or abnormal fat accumulation in the adipose tissue affecting various organs directly or indirectly. Generally, this condition develops due to quantitative imbalance between energy intake and expenditure causing an array of conditions like type 2 diabetes mellitus, cardiovascular diseases and coronary heart disease, certain cancers, osteoarthritis, gout and many more.

Obesity and Osteoarthritis (OA) Osteoarthritis is one of the most common form of arthritis causing a range of disorders resulting in structural and functional failure of synovial joints. It breaks the cartilage cushioning of the two joints causing bones to rub against each other thereby, altering its shape.

The association of obesity and Osteoarthritis was first documented in 1945 by Leach R.E. and very well stated that 83% of females that suffer from knee osteoarthritis are obese.' Though, excessive weight causing Osteoarthritis is widely acknowledged, the exact mechanism causing this is yet to be fully understood.

Many believe that in obesity, adipose tissue releases extra pro-inflammatory cytokines (adipokines) which is responsible for inflammation in synovial tissue leading to Osteoarthritis. Leptin, a hormone, also has a potential link, as its level increases in obese individuals.

Several non-pharmacological and pharmacological therapies are available for managing Osteoarthritis. Pillars for non-pharmacological therapy comprise of exercise to improve strength, avoiding activities causing joint pain, weight loss and use of aids like cane, brace or crutches to reduce stress on joint. Among all, weight loss is of utmost importance in overweight individuals as each pound of lost weight can decrease 3 to 6 folds of load across the knees. Pharmacotherapy includes intake of oral or topical drugs and/or intra-articular joint injections.

Obesity and Rheumatoid Arthritis (RA) The first description of Rheumatoid Arthritis can be found in a dissertation from 1800 by L. Beauvais which he named Goutte Asthenique Primitive meaning Primary Asthenic Gout. Persistently, its name has changed several times till A. Garrod coined the term Rheumatoid Arthritis in 1890.

Rheumatoid Arthritis is a condition which causes inflammation of various joints including fingers, wrists, shoulders, knees, ankles and other parts resulting in pain, disability and mortality.

Extra weight increases the amount of adipose tissue which produces adipocytokines (cytokines secreted by adipose tissue) and inflammatory cytokines (substance secreted by the cells of immune system which affects other cells) having immune-modulatory properties impacting inflammation. Likewise, obesity also leads to vitamin D deficiency and change in sex hormone levels which can lead to the development of Rheumatoid Arthritis

Several options are available for managing Rheumatoid Arthritis like medications (NSAIDs, Steroids, DMARDS), therapy and surgery. Surgery is only considered if medication fails to prevent or slows down the joint damage.

Obesity and Gout Gout is an old age disease which spans for thousands of years and appeared in medical records very early. Historically referred as King's disease' due to its close association with consuming large amounts of fatty foods and alcohol; as well as obesity.

High serum Uric Acid (UA) levels cause excess deposition of monosodium urate crystals in tissues, mainly in and around joints like elbow, toe, ankle, hand and others. Additionally, poor eating habits and lifestyle can lead to obesity in turn causing high insulin production. Higher levels of insulin inhibits elimination of uric acid from the kidneys leading to its deposition at certain joints. This excess accumulation results in gout and gout attacks.

Signs and Symptoms of various types of Arthritis - Osteoarthritis
Pain, reduced joint functions or movement and joint stiffness can be experienced along with bony enlargement of the joint, altered gait and muscle atrophy.

Rheumatoid Arthritis
Fatigue, fever, eye inflammation, anemia, weight loss, subcutaneous nodules (lump under the skin) or lung infection

Onset of symptoms occurs suddenly and often during night. Also, intense joint pain along with joint swelling/redness are observed.

Its management mainly depends upon lowering the blood uric acid level either by change in diet or intake of serum uric acid lowering drugs.

Can an Infection Cause Arthritis?
Arthritis from microbial infection. Isn't it shocking? But yes, it is true. A more alarming news is that it does not even spare infants from grabbing into it's claws. Typically it is a malady of the joints that has become common among the general population yet, not well understood. It is often misinterpreted as a disease of the elderly, but can attack people of any age group, race or either gender.

What is Septic Arthritis?
Septic Arthritis (SA) is an inflammatory condition of joints wherein joint fluid and synovial membrane are infected by disease causing microorganisms which cause deformity and irreversible degeneration. Studies state that around 4-10 out of 1,00,000 people become victims of Septic Arthritis every year. Individuals suffering from Septic Arthritis experience joints reddening, warmth and swelling with limited motion, and fever. The signs indicating the presence of Septic Arthritis may vary from one infectious agent to another.

Origin of Infectious Agents Most septic joints are a result of microbial colonization in joints which impair and restrict joint movements following are some common routes on infection
Through wounds
During joint surgery
human or animal bite nail puncture
injections , catheters

Direct Inoculation of bacteria during surgical replacement or reconstruction of joints has increasingly became a root cause of bacterial arthritis espesially in knee and hip operations.

How Infection Works?
Severity of the Septic Arthritis depends on the interaction of immune system and invading pathogen. At the initial stage, microbe enters the synovial membrane or cavity and colonizes round the joint. Several self healing proteins like fibronectin released for tissue repair after surgery aid the pathogenic colonization and its proliferation. As the disease progresses an acute inflammatory response is activated by the invading species. Sometimes these inflammatory responses from the infectious pathogens may evolve more slowly to become chronic worsening the patient's condition

Vulnerable Joints Although infection can occur to any joint of the body, knee and hip followed by shoulder, wrist, elbow and joints of the fingers are mostly affected by Septic Arthritis. Few species of Streptococcus and Staphylococcus are found to primarily affect joints of fingers, wrists, elbow, knee and ankle. In small children, hip infection is more frequent. Other joints susceptible to Septic Arthritis are sacroiliac joints (joint between sacrum and iliac), generally get infected by ingestion of unpasteurized dairy products. Also, soil exposure (gardening) may lead to the development of disease in hand and leg joints.

Diagnostic Approaches Investigation of abnormality related to joints is of utmost importance and should be diagnosed timely Following diagnostic techniques are considered viable to confirm Septic Arthritis.

blood testing reveals WBC count, erythrocyte sedimentation rate and C-reactive protein levels in the blood of Septic Arthritis patient that increases leading to the inflammatory responses against the microbe.

Synovial fluid analysis is a culturing technique which is performed by aspirating the fluid sample from patient and culturing it in blood culturing tubes to check the microbial growth. It gives almost 50% positive results among people with Septic Arthritis.

Radiographic imaging is a good indicator that can be used before starting specific Diagnostic Test. It is able to analyze swelling, fluid ccumulation and narrowing of joints due to cartilage destruction in later stages of illness or during treatment

Magnetic resonance Imaging (MRI) shows better resolution of soft tissues near joints and aid in screening of infection in individuals suspected with Septic Arthritis

Managing Sepsis To cope up with this painful malady treatment should be undertaken without any delay thereby avoiding cartilage and joints dysfunction and disease development. Late detection or recognition of Septic Arthritis leads to significant increase in rates of morbidity and mortality. Even after effective management there are chances of relapse or reinfections Therefore, it is important to aim early treatment, adherence to prescribed exercises and execute compliance to medication and therapies in order to keep troubles at bay .

Thyrocare offers rheumatoid factor (RF) Testing, a marker profile for the detection of rheumatoid arthritis using sophisticated and automated technology at highly affordable rates.


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