Arthritis

Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons; often the definite cause is not known. 

When the articular cartilage wears out the bone ends rub on one another and cause pain. This condition is referred to as Osteoarthritis or “wear and tear” arthritis as it occurs with aging and use. It is the most common type of arthritis.

Causes of arthritis

There are numerous conditions that can cause arthritis but often the exact cause is never known. In general, but not always, it affects people as they get older (Osteoarthritis). Other causes include:

  • Trauma (fracture)
  • Increased stress such as overuse and overweight
  • Infection of the bone
  • Connective tissue disorders
  • Inactive lifestyle and Obesity (overweight); Your weight is the single most important link between diet and arthritis as being overweight puts an additional burden on your hips, knees, ankles and feet.
  • Inflammation (Rheumatoid arthritis)

Symptoms

Knee Arthritis causes pain and decreased mobility of the knee joint. In the arthritic knee, there is an absent joint space that shows on X-ray.  In the normal knee, there is a normal joint space.

Arthritic knee

The cartilage lining is thinner than normal or completely absent. The degree of cartilage damage and inflammation varies with the type and stage of arthritis. The capsule of the arthritic knee is swollen. The joint space is narrowed and irregular in outline; this can be seen in an X-ray image.  Bone spurs or excessive bone can also build up around the edges of the joint. The combinations of these factors make the arthritic knee stiff and limit activities due to pain or fatigue.

Diagnosis

Evaluating the source of knee pain is critical in determining your treatment options for relief of the pain. Knee pain should be evaluated by an Orthopaedic specialist for proper diagnosis and treatment. Your physician will perform the following:

  • Medical History
  • Physical Examination

Depending on what the history and exam reveal, your doctor may order medical tests to determine the cause of your knee pain and to rule out other conditions. 

Diagnostic Studies may include: 

  • X-rays: X-rays are a form of electromagnetic radiation that is used to take pictures of bones.  An X-ray can reveal if osteoarthritis from degenerative changes is causing your knee pain. The diagnosis of osteoarthritis is made on history, physical examination & X-rays.
  • There is no blood test to diagnose Osteoarthritis (wear & tear arthritis).

Conservative Treatment Options

Conservative treatment options refer to management of the problem without surgery. Some conservative treatment measures for knee osteoarthritis include:

  • Activity Modification and Limitations
  • Weight Reduction
  • Anti-inflammatory Medications
  • Physical Therapy
  • Orthotics such as canes, braces, or insoles
  • Injection of steroid and analgesic into the knee joint


HARVARD MEDICAL SCHOOL ASHPP PENN SIS AMA NASS aaPM&R ISASS - The International Society for the Advancement of Spine Surgery