Osteoarthritis

Osteoarthritis (OA) is caused by the breakdown of articular cartilage tissue in joints. OA tends to occur more often in older age, either following damage to the cartilage (e.g. previous injuries or mechanical overload – such as long-term obesity) or as a general condition – see below. There is a lot we don't know about the factors that lead to why OA occurs very readily in some people and not others. Probably the genetic background matters - with some people have a better design of joint cartilage then others. OA leads to a structural degeneration of joints, and is best diagnosed on X-Ray as long as other arthritis types (e.g. psoriatic arthritis) have been ruled out.

Severe OA in a large joint such as a knee or hip, where pain prevents sleep and walking, is best treated by arthroplasty - a joint replacement operation undertaken by an Orthopaedic Surgeon.

One form of OA occurs 'out of the blue' in the small joints of the hands - often in middle age and often at the time of the menopause in women. This form of OA is not a consequence of mechanical injury or overuse but can start instead with a 'storm' of inflammatory symptoms in the affected joints (stiffness and pain). It can appear similar to rheumatoid arthritis (RA) and care is needed not to misdiagnose it as such.

Some doctors think, in some people, generalised small joint inflammatory OA can start together with other symptoms such as tiredness, dry mouth, dry eyes (SOX syndrome [Sialadenitis, Osteoarthritis, Xerostomia]) or can accompany the autoimmune connective tissue disease Sjögren's Syndrome.

Generalised small joint OA can often be associated with calcium crystal induced inflammation on joints - often in more elderly people. The commonest crystal which accumulates in and around joints which causes this is calcium pyrophosphate (CPP). The episodic inflammatory symptoms of CPP disease (CPPD) in joints can ‘punctuate’ the course of generalised small joint OA in elderly people notably.

Links:

Patient information at The UK medical charity. Search here under 'Arthritis Information’
https://www.versusarthritis.org/about-arthritis

For people with generalised osteoarthritis associated with CPPD see the following article: