Osteoarthritis is the commonest disease to affect joints. It is long thought to be the result of ageing and injury but it is not an inevitable consequence of growing old.

In osteoarthritis, there is focal cartilaginous loss and resultant bony reaction in the form of growth or sclerosis. X-ray remains the simple and most used test for diagnosis. An X-ray will show cartilage loss by reduction of joint space and resultant bone reaction will show as osteophytes or sclerosis. X-ray, however, may not show early or minimal osteoarthritis.

The level of symptoms does not have a direct relationship to the extent of osteoarthritis.

Osteoarthritis is strongly related to age and with the ageing population increasing, the burden on the health service is increasing.

It is uncommon in people under the age of 45 and at least half of 65s have X-ray evidence of osteoarthritis in at least on joint group but not necessarily any symptoms. Symptomatic osteoarthritis also increases with age.

In women there is higher incidence of X-ray evidence of severe osteoarthritis especially in the hand and knee. It is uncommon in blacks and Asians compared to white people. Polyarthritis of the hand is rare in black Africans and Malaysians. It is assumed there is a genetic cause.

Risk factors for developing osteoarthritis can be put into two categories.

General risk includes obesity and genetic factors.

Local risk includes mechanical problems such as meniscectomy and instability.

Genetics of osteoarthritis in not clear but there is a positive inheritance in osteoarthritis of the hand, hip and knee. Some factors such as obesity, occupation and use of joint can be areas where prevention is possible.

Dr. Phil Hariram.
Arthritis Treatment.