clinic
Osteoarthritis is characterized by articular signs and symptoms that occur subtly, usually after the age of 40 in the male and after the age of 55 in the female.
One or some of the following joints are preferably affected: distal interphalangeal (between the last two phalanges) and, less frequently, proximal (between the first and second phalanx); elbow and ankle joint; knees (particularly in the female sex), coxofemoral (hip) joint, cervical and lumbar spine (particularly in the male sex).
Symptoms
To learn more: Osteoarthritis symptoms
The main symptom is pain; it arises at first only during the articular movement, especially after a immobility of several hours, at morning awakening or through movements in sleep, with a piercing character; in later stages it appears also at rest, and it is deep and poorly localized, favored by a previous articular abuse or by meteorological changes. Morning stiffness lasts for a few minutes, but less than half an hour. The limitation of the movements can appear in phases of exacerbation of the disease and in the advanced stages, and is due to the muscular contracture that is unleashed as a defense against pain. The peripheral joints are swollen and have a hard ( wooden ) consistency due to the presence of osteophytes. Pain may be present on palpation of the joint and on its passive movement, during which a crackling, a roar or an articular click may be perceptible, due to the incongruity of the articular heads or due to the presence of free osteophytes in the articular cavity. Liquid pouring is rarely present; the joint may be hot, but the redness and swelling of the soft parts in continuation with it are rare, except during periods of flare-up of the inflammation.
In late stages, deformities and dislocations dominate, with ulnar or radial deviation (in the direction of the radius or ulna), phalanges, knee (varus or valgus) and hallux valgus; usually there is no total loss of function, except for the articulation of the hip and wrist.
Particularly frequent localizations are:
Osteoarthritis of the hand : often determines flexion and lateral deviation of the last phalanx, first to the second and fifth finger, then it becomes multiple and bilateral; in a third of the cases the proximal interphalangeal are also affected, rarely the wrist joint.
Osteoarthritis of the hip : it can appear in the average age or even earlier if it is secondary (60-80% of cases) to malformations, traumas, hip arthritis, rupture of the femoral head. Pain is acute when standing upright, or deep after a prolonged load. It can be felt along the lateral aspect of the thigh, in the groin, on the inner face of the thigh or on the knee. It causes a limping gait and an abnormally oblique pelvis.
Later on, a reduction in limb length, a severe motor limitation and a lordosis in the lumbar spine appear.
Osteoarthritis of the knee : frequent in women and in professional osteoarthritis, it gives rise to pain in the act of kneeling, climbing stairs, getting up or sitting down. The articular profile is irregular due to osteophytosis and an intense tenderness is felt accompanied by crackles in the passive movement. Additional symptoms include the inclusion of varus or more rarely valgus, reduced flexion or extension of the leg on the thigh, or loss of the ability to move the patella laterally.
Osteoarthritis of the foot : first determines a bursitis (inflammation of the bursa that wraps and protects the joint), and then the degeneration of the big toe joint, particularly subjected to load and traumatism due to walking, with evolution towards rigid hallux or valgus .
Osteoarthritis of the spine : the segments most affected are the lower sections of the lumbar and cervical spine, due to the greater mobility of the same column in these locations. At the cervical level it causes pain, stiffness and crackling movements; the osteophytes and the protrusion of the intervertebral disc (a structure that acts as a shock absorber between one vertebra and the other), determine the compression of the spinal nerve roots, which pass through these sites, causing pain radiated to the scapula and the arm, accompanied from tingling or difficulty in its movements. Osteoarthritis of the thoracic spine is rare in the absence of predisposing causes such as scoliosis. The lumbar one, favored by body weight and the presence of normal lumbar lordosis, is the most common cause of lumbar and sacral pain, and can cause sciatica, with pain and tingling irradiated to the front and lateral sides of the thigh and leg.
