Diseases of musculoskeletal
system
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4. Degenerative bone
diseases
Osteoarthritis
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ILOs
• Recognizing definition, pathophysiology,
clinical features and treatment of
osteoarthritis.
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* Definition:
- Degenerative disease affecting large joints (weightbearing).
- Age: usually old ages.
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* Etiology:
1. Primary osteoarthritis:
- It is of unknown cause.
- It affects the elderly.
- It occurs in a normal joint.
2. Secondary osteoarthritis:
- Occurs on top of an intra-articular or extra-articular
bone diseases e.g congenital hip dysplasia, malunion of
a fracture or bowing legs ….
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* Pathogenesis:
- The central part of the articular cartilage undergoes
cracklings & some pieces separate into the joint cavity
& the underlying bone becomes exposed.
- The peripheral parts of destructed cartilage proliferate
& ossify  osteophytes.
- Synovial membrane, capsule & ligaments undergoes
inflammation.
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* Symptoms:
• Pain and stiffness in the joints are the most common
symptoms. The pain is often worse after exercise.
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• The phrase "morning stiffness" refers to the pain and
stiffness you may feel when you first wake up in the
morning. Stiffness usually lasts for 30 minutes or
less.
• During the day, the pain may get worse when you're
active and feel better when you are resting. After a
while, the pain may be present when you are resting.
It may even wake you up at night.
• Some people might not have symptoms, even though
x-rays show the changes of OA.
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* Signs and tests:
- A physical exam can show:
• a cracking (grating) sound with the joint
movement. (called crepitation)
• Joint swelling (bones around the joints may
feel larger than normal)
• Limited range of motion
• Tenderness when the joint is pressed
• Normal movement is often painful
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* Pathological features:
The affected joints are: large joints, usually singly e.g.
knee or hip…
The affected joint shows;
- The synovial membrane and peri-articular tissue show
chronic non-specific inflammation and fibrosis.
- Degenerated central parts of articular cartilage.
- Osteophytes: bony projections along joint margins
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• Complications:
1- joint disability
1* Treatment:
1. Analgesics and anti-inflammatory drugs.
2. Joint replacement in severe disabling cases.
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