CHAPTER 6 Musculoskeletal System^271
Osteoarthritis
WHAT WENT WRONG?
A degenerative joint disease caused by the wear and tear of the articular cartilage.
As the protective joint cartilage is worn away, the underlying bone becomes ex-
posed, causing the exposed bones to rub. Degenerative changes within the bone
tissue produce small areas of re-growth, causing jagged joint spaces and bone spurs.
These rough areas project out into soft tissue or joint spaces, causing pain.
PROGNOSIS
Pain associated with osteoarthritis typically is related to activity and is relieved
with rest. The major weight-bearing joints are more affected in overweight patients
due to the excess wear and tear on the joints, especially affecting hips and knees.
Initially patients respond well to rest periods and over-the-counter medications for
pain control. As joints become more damaged over time, a joint replacement may
be necessary to correct pain and to improve quality of life and mobility.
HALLMARK SIGNS AND SYMPTOMS
- Stiff joints for short time in morning, usually 15 minutes or less due to changes
within joints - Joint pain with movement or weight bearing due to joint remodeling
- Crepitus (grating feeling on palpation over joint during range of motion) due
to loss of articular cartilage and bony overgrowth in joint - Pain relief when joints are rested because lack of movements will relieve irri-
tation in joint space - Enlargement of joint due to bony overgrowth or remodeling
- Heberden’s nodes—swelling of the distal interphalangeal joints
INTERPRETING TEST RESULTS
- X-ray shows narrowed joint spaces, bone spurs, or osteophytes around joints.
- Tests for inflammation will be normal—erythrocyte sedimentation rate, C-
reactive protein.
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