Osteoarthritis

“Degenerative joint disease”

Overview

Disorder of the synovial joint characterized

by local area loss and damage of articular
cartilage. The loss of proteoglycans from
the articular cartilage is the hallmark of
osteoarthritis.

Osteophytosis- New bone formation of

the joint margin.
 Proteoglycans

• Large complexes of numerous

polysaccharides attached to a common
protein core. They strengthen bone by
forming compression-resistant networks
between the collagen fibers.
Types of Osteoarthritis
Primary osteoarthritis
- mostly related to aging. With aging, the
water content of the cartilage increases, and
the protein makeup of cartilage degenerates.

Secondary osteoarthritis
- underlying causes that may lead to
osteoarthritis include: obesity, repeated trauma
or surgery to the joint structures, congenital
abnormalities of the joints, crystal deposits,
diabetes, and other hormone disorders.
 Persons
who put
exceptional
strength to the
joint.
Congenital, acquired skeletal deformities.
Long distance runners
Gymnast
Military Recruit
Obesity
Old age
colchicine, endomethacin, steroids
Pathophysiology of
Osteoarthritis
Obesity Crystal Congenital Drugs Aging
deposits in joint
the cartilages abnormalities

Increases mechanical
stress on cartilage
Cartilage become thin
Heberden’ Cyst develop within Bouchard’s
s subchondral bone Node
Node
Cartilage erodes,
Joint mice osteophytes grow
outward
Limitation of
movement Joint capsule thickened
Proteolytic,
Cytokine: IL 1 Collagenolytic
enzymes
Cartilage
degeneration

Eventual loss of
cartilage

Loss of
Proteoglycans
(DIP joint )

(PIP joint)
1. Acute pain
- sharp ache, or a burning sensation in the associate
muscles and tendons.
2. Crepitus
- crackling noise when the affected joint is moved or
touched.
3. Muscle spasm and contraction in the tendons.
4. In severe cases, osteoarthritis may cause pain at rest or
pain with limited motion.
5. Stiffness
- can occur after long periods of inactivity.
6. Swelling and warmth of affected joints.
Permanent disability Wrong posture
Pain and stiffness in the spine Avascular necrosis
 Nursing Diagnosis
• Acute Pain r/t destruction of cartilage secondary
to osteoarthritis

• Impaired Physical Mobility: Walking r/t discomfort

felt during usage of joints

• Ineffective Role Performance r/t changes in

ability to perform usual tasks as evidenced by
change in function of affected parts
 How to Diagnose

 The absence of synovial membrane

inflammation
 The lack of systemic s/s
 Normal synovial fluid.
- a sterile needle is used
to remove joint fluid for
analysis.

Arthrocentesis
Arthroscopy
surgical technique whereby a
doctor inserts a viewing tube
into the joint space.
Arthroscopy
 X-ray
helpful to exclude other
causes of pain in a
particular joint as well as
assist in decision making
as to when surgical
intervention should be
considered.
X-ray

Figure 1 is an X-ray of a normal knee with normal space between the

bones of the upper and lower leg. Figure 2 shows bone spurs and a
narrowed joint space caused by osteoarthritis.
End…