Osteoarthritis

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Osteoarthritis, abbreviated OA, is a degenerative disease of the joint.

General

Risks

It is associated with:[1]

  • Advanced age.
  • Trauma.
  • Unusual loading (bony misalignment, obesity).

Gross pathology/radiology

Features:[2]

  1. Loss of cartilage, especially asymmetrical.
    • Marble-like appearance - polished appearance known as eburnation.
  2. Osteophyte formation.
  3. Subchondral cysts - located where there is loss of cartilage.[3]
  4. Subchondral sclerosis.

Memory device LOSS:

  • Loss of cartilage, Osteophyte formation, Subchondral cysts, Subchondral sclerosis.

Notes:

  • Osteophytes are classically medial and lateral in the hip.[4]
    • They tend to form in areas with high loading.
  • Subchondral cysts are also seen in rheumatoid arthritis.[3]

Microscopic

Features:[5]

  • Vertical clefts of the cartilage - characteristic.
  • Thickening of bony trabeculae (reactive phenomenon) due to fibrosis.
  • Subchondral cysts (associated with cartilage loss).
  • +/-Mild inflammation (lymphocytes).
  • +/-Villous hyperplasia - synovium has finger-like projections into the joint space.
    • Normal synovium has a flat surface.
  • Osteophytes - ossified projections at the edge of the articular cartilage (bony spurs).

Images:

See also

References

  1. Martel-Pelletier, J.; Pelletier, JP. (Apr 2010). "Is osteoarthritis a disease involving only cartilage or other articular tissues?". Eklem Hastalik Cerrahisi 21 (1): 2-14. PMID 20302555. http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--www.tevak.org-images-Eklemlinkout.png.
  2. Swagerty, DL.; Hellinger, D. (Jul 2001). "Radiographic assessment of osteoarthritis.". Am Fam Physician 64 (2): 279-86. PMID 11476273. http://www.aafp.org/afp/2001/0715/p279.html.
  3. 3.0 3.1 Resnick, D.; Niwayama, G.; Coutts, RD. (May 1977). "Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint.". AJR Am J Roentgenol 128 (5): 799-806. PMID 404905.
  4. Claassen, H.; Tschirner, T. (Jan 2003). "Topographical and histological examination of osteophytes taken from arthrotic femoral heads.". Ann Anat 185 (1): 67-71. PMID 12597129.
  5. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 658. ISBN 978-0781765275.
  6. URL: http://www.medpath.info/MainContent/Skeletal/Joint_02.html. Accessed on: 10 November 2012.
  7. URL: http://www.med.nyu.edu/medicine/labs/abramsonlab/basic-arth-research.html. Accessed on: 10 November 2012.