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The Skeletal SystemOsteoarthrosis Clinical features, Diagnosis, Management, Prognosis, Osteoarthrosis (Osteoarthritis, Arthrosis or Degenerative Joint Disease) is not a single disease, but the end-result of a variety of patterns of joint failure. To a greater or lesser extent it is always characterised by both degeneration of articular cartilage and simultaneous proliferation of new bone, cartilage and connective tissue. The proliferative response results in some degree of remodelling of the joint contour. Inflammatory changes in the synovium are usually minor and secondary. By the age of 65, 80% of people have radiographic evidence of osteoarthrosis although only 25% may have symptoms. Males and females are both affected but osteoarthrosis is more generalised and more severe in older women. Cold, damp climates are associated with more symptoms but not with greater radiological prevalence. Osteoarthrosis is classified as primary if the aetiology is unknown and
secondary when degenerative joint changes occur in response to a recognisable
local or systemic factor.
Hyaline cartilage in the joints is an avascular structure composed of 95% water and extracellular cartilage matrix and only 5% chondrocytes (cartilage cells). Cartilage health and function depend on compression and release of weight bearing and use; e.g., compression pumps fluid from the cartilage into the joint space and then into venules, whereas release allows the cartilage to re-expand and absorb necessary nutrients. It is possible that repetitive loading or other unknown factors cause fatigue fracture of the collagen fibre network in the cartilage. As the process evolves, the cartilage surface becomes cracked and deep clefts appear, which can lead to microfractures and increased production of the subchondral bone. Proliferation of chondrocytes and osteoblast eventually forms characteristic spurs composed of new bone and cartilage (osteophytes or more correctly osteochrondrophytes). Disease pathology includes roughening pitting and irregularities of the hyaline cartilage surface, proceeding to gross ulceration with focal and then diffuse areas of complete loss of cartilage, leaving only exposed bony surfaces. Clinical features: < BACK TO TOP >
Diagnosis: < BACK TO TOP >
Management < BACK TO TOP >
Prognosis < BACK TO TOP >
(source :
Dr Zoran Pletikosa) |
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