Osteoarthritis : Symptom, Risk Factor, Affected Area, Diagnosis, Grading Scale, Treatment, And Drug

Osteoarthritis (OA) or Degenerative joint diseases is joint disease type that results from breakdown of joint cartilage and underlying bone.It occurs in people of all ages.Osteoarthritis usually happens in people older than sixty five years old.Osteoarthritis symptoms depend on which joints are affected and how severely they are affected.It is caused by mechanical stress on the joint and low grade inflammatory process.It develops as cartilage is lost and the underlying bone become affected.Osteoarthritis can cause crackling noise (crepitus) when the affected joint is moved or touched.

The Symptoms of Osteoarthritis

• Joint pain
• Joint swelling
• Stiffness
• Tenderness
• Reduced range of motion
• Loss of flexibility
• Numbness of the arms and legs or weakness
• Burning sensation
• Bone spurs
• Clicking or cracking sound when a joint bends

Risk Factors of Osteoarthritis

• Genetics
• Older Age
• Gender
• Obesity
• Joint injuries
• Certain occupations
• Bone Deformities
• Changes in sex hormone levels
• Diabetes
• Rheumatic 
• Gout

Parts of Body can be affected  by Osteoarthritis

• Hips
• Knees
• Fingers
• Feet
• Lower back
• Neck
• At the base of the thumb and big toe
• Hand
• Spine

Diagnosis of Osteoarthritis

• Medical Hystory is to get information about Patient"s health habit, past illness, and treatment.
• Physical Examination is to examine the body from signs or symptoms of colon cancer.
• Blood Test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle or via fingerprick.It is to determine physiological and biochemical states, including disease, mineral content, organ function and pharmaceutical drug effectiveness.
• Joint Aspiration in which doctor numbs the affected area and inserts a needle into the joint to withdraw fluid.
• X-Ray is an x-ray of organs and bones inside the chest.
• Magnetic Resonance Imaging (MRI) is a procedure that uses a magnet, radio, wave, and computer to make a series of detailed pictures of areas inside the body.

Classification System for Gradation of Osteoarthritis (OA)

• WOMAC SCALE

The Western  Ontario and McMaster Universities Arthritis Index (Womac) is a set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.A womac test takes about twelve minutes, but is available in a short form.

WOMAC measures :

• Five items for pain : Score range 0 - 20
• Two items for stiffness : Score range 0 - 8
• Seventeen items for functional limitation : Score range 0 - 68

Physical Functional questions cover daily activities :

• Stair use
• Standing up from a sitting or lying pisition
• Standing
• Bending
• Walking
• Sitting
• Lying in the bed
• Shopping
• Getting in and out of a car
• Getting in or out of a bath
• Putting on or taking off socks
• Heavy and light household duties

• KELLGREN- LAWRENCE Grading Scale

The KELLGREN-LAWRENCE Grade (K-L System) is a scoring tool used to assess the severity of knee osteoarthritis on a plain radiograph.

KELLGREN -LAWRENCE SCALE :

• GRADE 0 : No radiographic features of osteoarthritis.
• GRADE 1 : Possible joint space narrowing and osteophyte information.
• GRADE 2 : Definite osteophyte formation with pissible joint space narrowing.
• GRADE 3 : Multiple osteophytes, definite joint space narrowing, sclerosis and possible bony deformity.
• GRADE 4 : Large osteophytes, marked joint space narrowing, severe sclerosis and definite bony deformity.

Treatment of Osteoarthritis

I. Physical Therapy

• Weight Management is to eat fewer calories and increase physical activity for losing weight.Losing weight is to reduce pain and limit further joint damage for people with osteoarthritis.
• Stretching of joint slowly and gently can improve flexibility, lessen stiffness and decrease pain.Yoga and Taichi can be done.

II. Pain and Anti-Inflammatory Medications, including pill, syrup, injection, cream or lotion.

III. Physical Occupational Therapy

• Heat and Cold Therapies.
• Range of motion and Flexibility exercises.
• Assistive Devices, such as canes, splints, steering wheel grisps, custom knee braces, shoe orthotics that help in function and mobility.

IV. Natural and Alternative Therapies

• Nutritional Supplements, such as Glucosamine Sulfate and Chondroitin.Glucosamine should not be used for people in allergy of shellfish.A mixture of avocado with soybean oil can treat knee and hip osteoarthritis.
• Massage
• Acupunture or acupressure
• Hydrotherapy
• Relaxation Teqhniques

V. Surgery

• Joint Replacement Surgery (Arthroplasty) is to repair or replace severely damaged joints, especially hips or knees.
• Osteotomy is a surgery that cuts across the bone either above or below the knee to realign the leg.It reduces knee pain by shifting the body weight away from the worn-out part of the knee.

VI. Lifestyle and Home Remedies

• Exercises, such as swimming, walking, biking.
• Apply over-the counter pain cream.

Drugs For Osteoarthritis

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including ibuprofen (Motrin IB, Advil), aspirin, COX-2 Selective Inhibitors (celecoxib), and naproxen (Aleve) that can ease inflammation and relieve pain.NSAIDs should not be used for people in over sixty five years old and stomach bleeding.The side effects are stomach upset, beeding problems, and ringing in the ears.The use of diclofenac is for topical.
• Analgesics, such as Acetaminophen (Tylenol), tramadol that can relieve pain.
• Corticosteroids are anti-inflammatory drugs that are taken by mouth or injected into a joint.
• Hyaluronic Acid acts as a shock absorber and lubricant.