Articular cartilage destruction occurs due to biomechanical stress and aging and genetic components.
Factors such as obesity, muscle strength, and joint stability, structure and alignment can lead to biomechanical stress.
The risk of OA increases greatly in individuals over the age of 50. It is a degenerative disease, and is seen in patients who are older, as they have had more use of their joints than younger individuals.
Unlike in rheumatoid arthritis, OA presents with asymmetric joint involvement.
Unlike in rheumatoid arthritis where pain improves with use, in OA pain improves with rest.
Patients with OA complain of morning stiffness that lasts a short time (usually under 30 minutes). This is unlike patients with RA who will typically complain of morning stiffness that lasts greater than 30 minutes.
Crepitus is an audible or palpable crackling that occurs upon joint movement. This grating sensation is caused by loose cartilage particles in the joint area that contributes to stiffness.
OA affects the DIP and PIP joints unlike RA which affects the PIP and MCP joints. Heberden’s nodes affecting the DIP joint and Bouchard’s nodes affecting the PIP joint can be seen.
Weight loss and exercise are recommended for the patient, as excess weight can lead to increased joint degeneration.
Painkillers are often used to help the patient deal with the pain. NSAIDS are avoided in older patients that may be more susceptible to GI bleeds. Intra-articular corticosteroid injections are sometimes used to decrease pain over the short term.
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