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Definition of Osteoarthritis


Osteoarthritis is the progressive destruction of joint cartilage, common in advancing age (degenerative joint disease), which can be up to his disappearance.

Most joints can be affected by osteoarthritis, but it is most often in the spine, hips (hip), knee (gonarthrosis) and hands. There is a hereditary factor with a genetic predisposition family more or less marked.

Origins and consequences of osteoarthritis
Osteoarthritis is a degenerative disease very common, affecting more than half of Europeans over 65 years, and 80% of them beyond 75 years (J. Avouac, Society of Rheumatology, 2009). It is not always painful or enraidissante: this only occur in 15-20% of cases (Valat, 2008). Radiographic lesions are not good witnesses functional status, he does not have a "parallelism anatomo-clinical" as explained by doctors. We can have dramatic radiographic images and not feel pain and / or functional impairment important. The reverse is also true.

In the White Paper of Rheumatology (Society of Rheumatology - SFR), its prevalence is estimated at around 17% between 9 and 10 million people affected. The annual incidence of symptomatic knee osteoarthritis is estimated at 240 per 100 000 persons / year, the digital symptomatic OA at 100 100 000 and that of symptomatic osteoarthritis at 80 per 100 000.

Often taken "lightly" because non-lethal, yet sounds osteoarthritis of patient autonomy (which is particularly damaging to old age), especially due to osteoarthritis of the hands. The development also depends on the care and lifestyle is applied early.

Causes and signs of osteoarthritis
The cartilage allows the bone ends to slide over each other. So its alteration causes joint stiffness or ankylosis (stiffness painful).

The causes of cartilage damage due to cellular aging first "natural" then local excess pressure, mainly by joint overuse (sport, leisure, occupation ...). Overweight and obesity are a major cause of osteoarthritis, they exacerbate the consequences of an anatomical abnormality (constitutional, hereditary or not). Obesity has, moreover, a hormonal influence pro-inflammatory (interleukin).

Degenerating cartilage fragments, debris falls into the joint and leads to additional local inflammation of the synovium (joint synovial fluid that lubricates and nourishes the cartilage). Pain reduced movements, the muscles atrophy, tendons become inflamed in turn, the joint stiffens. The adjacent bone responds by deforming (osteophytes or parrot beaks) and fragile.

Osteoarthritis is compounded by the joint crystallization of substances such as uric acid (gout) or calcium phosphates (CPPD), long silent disease and often overlooked.

Symptoms of Osteoarthritis
Osteoarthritis is manifested by painful outbreaks that reflect cartilage destruction (release of inflammatory substances, the source of pain). They can occur only two or three per year or, on the contrary, persist in painful background of different intensities for several years. There are very progressive forms of osteoarthritis requiring rapid intervention physicians.

Pain is the first symptom. Outside inflammatory attacks, it is moderate and mechanical: it increases during the day. During outbreaks, the pain is sharp in the morning with a persistent discomfort in the day. Nocturnal pain may also occur. Joint inflammation can be intense enough to go to redness with swelling of the joint. We are then in a table arthritis.

Eventually, without treatment, the destruction of cartilage and inflammation cause local bone deformities and decreased motor skills. They maintain the status quo so joint damage by the persistence of inflammatory substances. It is a vicious circle.

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