is permanent. Osteoarthritis is a leading cause of
disability in the United States.
Symptoms and Diagnostic PathMany people who have osteoarthritis sufficient to
show up on X-RAYhave few if any symptoms.
Researchers estimate that by age 60, more than
half of Americans have radiologic evidence of
osteoarthritis. However, fewer than 20 percent of
Americans seek medical treatment for symptoms
of osteoarthritis. Stiffness and PAINin the joints are
the main symptoms of osteoarthritis. Discomfort is
usually greatest in the morning when first getting
out of bed and after physical activity.
The diagnostic path may include X-ray to assess
the extend of damage within painful joints. But
because the damage primarily affects cartilage, a
soft tissue, the full extent of osteoarthritis is not
likely to be apparent with X-ray. The doctor may
request other diagnostic procedures to rule out
conditions that have similar symptoms. However,
a detailed PERSONAL HEALTH HISTORYin combination
with a comprehensive medical examination is
generally sufficient for the doctor to make the
diagnosis.
Treatment Options and Outlook
Treatment for osteoarthritis attempts to slow the
degeneration by reducing INFLAMMATION. NON-
STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) and
injections of CORTICOSTEROID MEDICATIONSare very
effective in accomplishing this goal. NSAIDs also
relieve pain. Other treatment includes easing the
stress on the joints, daily physical exercise for
WEIGHT LOSS AND WEIGHT MANAGEMENT, and meas-
ures such as moist heat to affected joints. Exercises
can strengthen the muscles and other structures of
the joints. YOGAis excellent for improving range of
motion and FLEXIBILITY.
Though there are no treatments that can cure
osteoarthritis, a blend of medical therapies and
lifestyle modifications can keep symptoms in
check. Many people who have osteoarthritis are
able to enjoy favorite activities with few if any
restrictions when they follow appropriate meas-
ures to control future damage of the joints. Signif-
icant damage to the joint may require joint
replacement.
Risk Factors and Preventive Measures
The primary risk for osteoarthritis is increased age.
Osteoarthritis is uncommon in people under age- Early diagnosis allows early treatment, which
helps prevent further deterioration of the involved
JOINT. Because so many factors converge to estab-
lish osteoarthritis, there are no measures known
to prevent it.
See also ANKYLOSING SPONDYLITIS; EXERCISE AND
HEALTH; INFECTIOUS ARTHRITIS; REITER’S SYNDROME;
RHEUMATOID ARTHRITIS; SPINAL STENOSIS.
osteochondrosis See OSGOOD-SCHLATTER DISEASE.osteogenesis imperfecta A genetic disorder,
commonly called brittle BONEdisease, in which
there are defects in the ways the body produces
type 1 collagen, a fibrous protein that is the foun-
dation of bone formation. As a result the bones
lack proper structure and density and are highly
susceptible to FRACTURE. The defective collagen
may affect other structures in the body as well,
notably the LUNGS. HEARING LOSSis also common.
Most osteogenesis imperfecta is inherited though
may occur as the result of spontaneous MUTATION.
There are four types of osteogenesis imperfecta:- Type 1 osteogenesis is the most common. Peo-
ple who have type 1 disease generally reach
normal height and have few obvious skeletal
deformities. Type 1 osteogenesis imperfecta typ-
ically causes more fractures during childhood
than in adulthood. Hearing loss is pronounced
and begins early in childhood. - Type 2 osteogenesis imperfecta is the most rare
and the most severe. It produces numerous
deformities of the SKELETONand often is fatal in
infancy. The abnormal collagen formation also
profoundly affects the lungs, causing significant
BREATHINGproblems. - Type 3 osteogenesis imperfecta produces obvi-
ous skeletal deformities. Fractures before birth
are common; ULTRASOUND can detect them in
the FETUS. Type 3 disease also affects the lungs
and muscles. Hearing loss begins in early child-
hood and often becomes complete by ADOLES-
CENCE.
342 The Musculoskeletal System