From time immemorial, Osteoarthritis is a disease which has been associated with the degeneration of cartilage without inflammation. In fact, it has been set aside from the rest and termed as a non-inflammatory arthritis. However, recent clinical advances in the study of the disease have made conclusions that bridge the gap between osteoarthritis and inflammation. One of the major breakthroughs in this study is the link between synovitis and osteoarthritis.
Synovial Inflammation in Osteoarthritis
Synovitis is regarded as the inflammation of the synovial membrane. A large number of primary osteoarthritis patients suffer synovitis and basing the study on these patients, inflammation of joints doubled with synovitis are implicated in osteoarthritis pathogenesis. It can however be concluded that clinical osteoarthritis is not as a result of one risk facto but many environmental and biochemical processes that work together culminating their focal point to the severity and progression of osteoarthritis. Such factors may include age, heredity, obesity, injuries or joint trauma.
Calcium Crystals in OA joints
There is calcium crystals deposited in the Synovium of advanced OA patients. There is evidence that these crystals act as great contributors in the inflammation of OA joints. These crystals have been known to interact directly with the innate immune system. They trigger or amplify the signals involved with inflammation. Fuerst.et.al in his study found about 30% to 60% of crystals in the synovial fluid of unselected OA patients. When he took 100% of the Synovium from the cartilage of a patient undergoing a joint replacement, the Synovium contained about 20% of calcium crystals. It is deduced that these crystals come from the cartilage into the synovial fluid through injury or mechanically.
Acute and Chronic Inflammation in OA
This pain is as a result of synovitis in OA. The severity of pain in both differs although OA patients may go through both. Acute pain may be experienced alongside chronic pain and sometimes in a joint which is not inflamed.
Acute inflammation occurs suddenly, its symptoms show up within minutes or even hours and they include swelling, soreness, heat, pain and redness of the joint. Cells known as neutrophils are in large numbers in acute inflammation.
Chronic inflammation bears symptoms which are spread over a lengthened period of time. One of the basic features of this inflammation is that the repair and inflammation happen at the same time. The joint does not return to normal even after inflammation stops. Cells known as macrophages are in plenty in chronic inflammation.
The triggers of acute inflammation may vary. Some activities are highly attributed to cause acute pain which narrows that to trauma in the joint playing a major role. Calcium crystals may also be a possible trigger of the pain in OA. Pain is the main symptom of acute inflammation though not limited to it. It occurs when the sensory nerves found in the OA joint are triggered to send signals of pain to the brain. The pain is not limited to acute inflammation as chronic inflammation also plays part in causing pain in OA.
When it is Inflammatory OA
Another name of this form of OA is erosive OA. Typically OA is termed as a non-inflammatory OA but then there exists another form which is takes a slightly different dimension. This form of OA is characterized by sudden pain and swelling of finger joints. Inflammatory OA can easily be taken for other inflammatory forms of arthritis like RA. Care should be taken that one does not draw conclusions rather see a medical practitioner who will diagnose the real condition. Remember the treatment administered to Inflammatory OA is different from that of ordinary OA and RA.
Symptoms of Inflammatory OA
It starts with sudden acute pain on the finger joints then they become tender and inflamed. The primary characteristic is erosion of the cartilage in the joints seen on plain radiographs. The joints feel stiff especially in the morning and this stiffness can continue even for an hour or two. Throbbing and complete numbness is another symptom that occurs with Inflammatory OA. Advanced progression of this disease may render the hand deformed and unable to function.
It Affects the Hand
Inflammatory OA is also known as erosive OA and it affects the hand joints. Inflammatory features in the hand joints are observed in the patient. The characteristics are sometimes taken for rheumatoid arthritis and psoriatic arthritis. The middle joints of the finger and those adjacent to the finger nails are most affected by inflammatory OA.
Possible Causes and Treatment
Findings done by Peter et al concluded that there is a link in this disease with synovitis on the inflammatory phase. Patients demonstrated a high breakdown of cartilage in the joint fingers and high levels of serum marking cartilage metabolism. Where the joints have swollen nodes, chances of genetics playing a role are possible.
Treatment is done by controlling the progression of the symptoms of Inflammatory OA. If you have been diagnosed with the disorder, engage in activities that check the pain. They may include and not limits to:
- Application of moist heat to the affected joints
- Use of paraffin baths where you thermally get a relief of the aching joints where you can do it from home and not necessarily going to the spa
- Splinting is applicable to ease your pain by and increase* mobility to the joint. The splints should be tied in a way that does not completely limit the functionality of the hand.
- Finger exercises are good toot to strengthen the muscles and ease the pain that comes with inflammatory OA. Find the best that suit you by involving a physiotherapist.
Drugs administration will be determined by the doctor. Mostly non-steroidal NSAIDs are used to ease the pain though the dosage can be prohibitive to those advanced in age. Some patients respond to intra-articular injections though they are very painful to take due to the small size of the joint. These injections only relief the pain and do not make the erosion of the joint to stop.