OSTEOARTHRITIS (OA)
OA is considered primary when no etiology can be clearly identified and secondary when the disease develops in response to injuries such as joint trauma, ligament injury causing instability, Paget’s disease, Ehlers-Danlos (congenital joint laxity), or congenital malformation of a joint. Twin and family studies have shown a multifactorial pattern in primary OA. Precocious OA (onset early in life) has been associated with a mutation in the gene coding for Type II collagen.
The initial changes in OA are found in the superficial zone of the articular cartilage and consist of an increased water content of the articular cartilage and loss of proteoglycan. Proteolytic degradation of proteoglycan reduces its chain length and inhibits
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It also commonly develops in small joints in the hands (called “nodal OA”), particularly *the DIP (distal interphalangeal ) and the PIP (proximal interphalangeal) joints, coupled with the first carpo-metacarpal joint (base of the thumb) but it typically *spares the metacarpophalangeal joints (MCP) of the fingers. Development of marginal or peripheral bone spurs (“osteophytes”) is one of the characteristic findings of OA. Osteophytes at the DIP joints are known as Heberden’s nodes; those at the PIP joints are called Bouchard’s …show more content…
There is a very strong association with the phenotypic frequency of the histocompatibility antigen, HLA-B27, particularly in Caucasians. Infectious agents (e.g., Shigella from the gastrointestinal tract) may be involved in triggering the disease. There is a strong overlap between the arthritis associated with inflammatory bowel disease and ankylosing spondylitis. Many patients with IBD develop a degree of spondylitis, and many patients with ankylosing spondylitis have evidence of bowel inflammation on biopsy.
Clinical Features
**AS and other spondyloarthopathies are characterized by three features: (1) insidious but sometimes abrupt onset in patients under age 40, (2) duration of symptoms more than 3 months, and (3) morning stiffness which improves with exercise. The joints characteristically affected are the sacroiliac joints, the lumber vertebrae, thoracic and cervical vertebrae, the hips and rarely the peripheral joints. A patient with bilateral sacroiliitis without the features of Reiter’s syndrome (see below), psoriasis, or inflammatory bowel disease, may be diagnosed with AS if there is also limitation in motion of the spine.
Women rarely are diagnosed with AS. The reason for this protective effect of patient sex is not understood. Women can have low back pain and bilateral sacroillitis, but the spine is rarely
Progression of osteoarthritis involves of three stages. Stage 1 start from cartilage matrix breakdown follow by cartilage fibrillation and erosion. Disease continues to progress to stage three where synovial inflammation started. With inflamed synovial, synovial membrane produced cytokines, particularly inflammatory cytokines and growth factors which both able to diffuse through synovial fluid and enter the cartilage. This will activates pro-inflammatory cytokines (Pelletier et al, 1999).In short, cartilage breakdown or degrade will lead erosion and release pro-inflammatory cytokine which in turn contribute to joint destruction. In an osteoarthritis knee, Examples of pro-inflammatory cytokines are interleukin-1, IL-1 and tumour necrosis factor alpha, TNF-α.
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage on the ends of your bones wears down over time. Most people don't know they have it because the aches, tenderness, stiffness dont feel like arthritis until x-rays prove it. Just like regular arthritis, it affects the skeletal system. This is because it causes the bones to wear and then become stiff.Primary osteoarthritis, osteoarthritis not resulting from injury or disease, is mostly a result of natural aging of the joint. With aging, the water content of the cartilage increases, and the protein makeup of cartilage degenerates. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses.Secondary
Ankylosing spondylitis usually starts in the sacroiliac joints, which connect the spine and the pelvis together. In fact, the telltale sign that joint inflammation is caused by AS, and not another type of arthritis, is chronic lower back pain that is worse in the morning, feels better after exercising, and seems to come and go in flares for no apparent reason. The pain can fluctuate from side to side in the sacroiliac joint.
In osteoarthritis, the cartilage at the end of bones wears down and produces rough, hard, edges of bone which cause trouble. This generally begins after 40, and 16 million in the U.S. have it. In rheumatoid arthritis, the cartilage at the end of bones is destroyed and is replaced with scar tissue. Then swelling occurs, and the joints may eventually fuse together. While osteoarthritis only affects individual joints, rheumatoid arthritis ultimately affects all synovial joints in a person's body.
Patient is diagnosed with lumbar arthrodesis and bilateral sacroiliac joint dysfunction. She is status post bilateral sacroiliac joint arthrodesis with X-spine instrumentation in 06/08/2015.
This is because the disease is hereditary. The major gene that causes ankylosing spondylitis, according to John D. Reveille, MD of the American College of Rheumatology, is HLA-B27. However, up to 30 genes have been known to cause the disease. Ankylosing spondylitis is a somewhat rare disease. Based on data from the National Health and Nutrition Examination Survey, the frequency of ankylosing spondylitis in the U.S. is 0.5 percent (Reveille, 2013). To diagnose ankylosing spondylitis, the doctor will rely on medical history, a physical examination of joints and spine, imaging test of the pelvis, and also a blood test to check for the HLA-B27 gene. Having the HLA-B27 gene doesn’t specifically mean that someone has ankylosing spondylitis; but it is a clue to help support the diagnosis (Ankylosing Spondylitis, 2016). The diagnosis relies on the doctor’s judgment overall. The treatment focuses on reducing pain and stiffness, preventing deformities, and allowing for patients to lead normal, healthy lives. All patients with ankylosing spondylitis should get physical therapy and do exercises that promote spinal extension and mobility. The doctor may
The average participant was a white and was around the age of 32. Close to one-third of the participants were female and two-thirds were males. They all had an average symptom duration of 2-and-a-half-years along with the average baseline BASDAI score of about 5.9 and a bone marrow edema SPARCC score of at least 2. Of all the participants, an MRI found that 82% had sacroiliitis, it also found that 70% had inflammation.
According to Goodman and Fuller (2009) Osteoarthritis is divided into 2 classifications: Primary and secondary. Primary OA is a disorder of unknown cause which in the cascade of joint degeneration it is believed to be a related defect in the articular cartilage. Secondary OA has a known cause, which may be trauma, infection, hemarthrosis, osteonecrosis, or some condition Primary Osteoarthritis (OA) is the most common joint disorder in the world and often affects the knee and hip joints (Rubak, Svendsen, Soballe, & Frost, 2013). For patients with primary hip OA, pain and disability are the most important indications for total hip replacement (THR) (Rubake et al., 2013, p.486) Primary symptoms of OA include joint pain, stiffness, and limitation of movement. Disease progression is usually slow but can
The tibiotalar joint is more resistant to development of primary OA than hips or knees (14). Primary ankle OA is estimated to occur in 1% of the population (11,22) and generally results from trauma, in up to 78% of reports. (10-12,19). The remaining 12% of ankle arthritis result from neuroarthropathy, rheumatoid arthritis (51), hemochromatosis, and inflammatory arthropathies (10-12,19). Sitting cross-legged or with legs tucked under can also contribute to arthritic changes in the ankle in up to 20% of patients(28,24).
Developmental spondylolisthesis occurs when someone has inherited the disease, along with Acquired spondylolisthesis is when a patient has placed tremendous strain on their body otherwise has attained a single force if not multiple forces to the spinal range (Rodts, 1). Six different types of levels that can be used for diagnosis determinations. Type I is positioned mainly in the L5-S1 area therefore partakes a dysplastic or congenital in the articular process (Highsmith, 1). Type II includes three different forms of correlated to its malfunction; Complete fracture of the Pars is due to overreach or use, Micro-fractures of the pars that cultivate new pars which at that time thrust old pars into an onward position, also Complete fracture can be triggered by trauma to the area (Highsmith, 1). Type III comes along with the aging process. Frequently seen in women over 50 and positioned in the L4-5 (Highsmith, 1). Type IV suffer through fractures of the vertebra along the pars at that point the facet joints separated (Highsmith, 1). Type V are due to tumors that enhance instability furthermore induces the slipping effect (Highsmith, 1). Type VI is a consequence of deteriorated pars after a laminectomy surgery (Highsmith, 1). Degeneration of the spine causes the disc to alter to a brittle state (Highsmith, 1). Having a
Ankylosing spondylitis is a genetic condition where the vertebrae mutate and fuse together to cause stiffness, pain and deformities. The condition mostly affects young men ranging in their teens to twenties. Early diagnosis is especially important to avoid cases of locked posture and/or spinal distortion.
However, humans are not the only ones to experience this degenerative joint disease. Scientists have found fossils, showing osteoarthritis in many animals, including dinosaurs (Jurmain and Kilgore, 1995:443). These pathological lesions are universal and can be identified, enabling us to comprehend how humanity has developed (Larsen, 1997:165). There are multiple reasons for osteoarthritis to form and can include repetitive use of our joints from exercise, activity, work, or even forced labor brought on during
DOI: 05/01/2001. This is a 71-year old female teacher’s aide who sustained injuries to her back and bilateral knees as a result of tripping on the sidewalk. The patient is subsequently diagnosed with lumbar, spondylosis without myelopathy or radiculopathy; and low back pain.
By first simply breaking apart the name "Ankylosing Spondylarthritis" into it's separate terms "Ankylosing" and "Spondylarthritis" we can perhaps derive a better idea of this disease. The root term of Anklylosing, which is ankylosis, indicates that this is an anklyosis based arthritic disease. Ankylosis arises when articular cartilage degenerates and the joints ossify. Ossify is derived from ossification which is when bone or boney tissue forms. Thus this means that ankylosis is when cartilage between bone degenerates and the bones, that were once separated by cartilage, now begin to fuse together and solidify. The second term which is "Spondylarthritis", contains the root term spondylitis, which indicates an inflammation of the vertebra of