Osteoarthritis (OA), or degenerative joint disease (DJD), is the most common of the arthritides.
Because the osteoarthritis is not primarily an inflammatory process, some authors prefer the term osteoarthrosis instead.
Primary OA is the less common variant and is characterised by the absence of an antecedent insult, it is considered to be hereditary and affects primarily middle-aged women.
The hallmarks of DJD are joint space narrowing, sclerosis, and osteophytosis. If all three of these findings are not present, another diagnosis should be considered.
Joint space narrowing
- characteristically asymmetric in DJD
- least specific findings for DJD, though present in most cases
- joint space narrowing in other arthritides is usually symmetric
- sclerotic changes occur at joint margins
- frequently seen unless severe osteoporosis is present
- are a common DJD finding
- will also be diminished in the setting of osteoporosis
- some osteophytes carry eponymous names, as discussed below
It affects the distal interphalangeal joints (Heberden nodes), the proximal interphalangeal joints (Bouchard nodes), (mnemonic H-D, B-P) and the base of the thumb in a bilaterally symmetric fashion. If it is not bilaterally symmetric, the diagnosis of primary osteoarthritis should be questioned.
- several joints exhibit erosions as a manifestation of DJD
- temporomandibular joint
- acromioclavicular joint
- sacroiliac joints
- symphysis pubis
- also known as geode
- cystic formations that occur around joints in a variety of disorders, including DJD, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition disease (CPPD) and avascular necrosis.
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- seronegative spondyloarthritides
- Jaccoud arthropathy
- juvenile idiopathic arthritis
- lyme arthritis
- rheumatoid arthritis
- systemic lupus erythematosus
- erosive osteoarthritis
- osteoarthritis (mnemonic)
- primary cystic arthrosis of the hip
- rapidly destructive osteoarthritis of the hip
- secondary synovial osteochondromatosis
- miscellaneous disorders
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