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Initial analgesic therapy is acetaminophen, while some are responsive to NSAIDs, COX-2 enzyme blockers, opioids, and intra-articular corticosteroids. Devices such as splints and braces can be used to support inflamed joints. The patient should avoid joint overuse and rest the joints regularly. Weight reduction is strongly recommended for obese patients to avoid further damage to the cartilage. To reduce the pain, heat application can be performed over the joints. Medical management involves conservative measures, physical modalities, and alternative therapies. OA is characterized by a progressive loss of joint cartilage, which appears on x-ray as a narrowing of the joint space. Physical assessment of the musculoskeletal system reveals the tender and swollen joints. Congenital and developmental disorders of the hip are well known for predisposing a person to OA of the hip.ĭiagnosis of osteoarthritis is complicated only because of 30% of patients with changes seen on x-ray report symptoms. Perinatal screening for congenital hip disease.As one of the risk factors for osteoarthritis is previous joint damage, it is best to avoid any injury that might befall the weight-bearing joints. To avoid too much weight upon the joints, reduction of weight is recommended. Functional impairment results from pain on movement and limited motion caused by structural changes in the joints.Īlthough no treatment halts the degenerative process, certain preventive measures can slow the progress if undertaken early enough. Stiffness, which is mostly experienced in the morning or upon awakening, usually lasts less than 30 minutes and decreases with movement. Inflamed synovium causes the pain, stretching of the joint capsule or ligaments, irritation of the nerve endings in periosteum over osteophytes, trabecular microfracture, intraosseous, hypertension, bursitis, tendinitis, and muscle spasm. Osteoarthritis has primary signs and symptoms, and that includes: Repetitive use due to occupational or recreational factors also causes OA. Having previous joint damage predisposes the patient to secondary OA. Obese people easily wear out their weight-bearing joints because of their increased weight. Most elderly people experience osteoarthritis because the ability of the articular cartilage to resist microfracture with repetitive loads diminishes with age. Understanding of osteoarthritis has been greatly expanded beyond what was previously thought of as simply “wear and tear” related to aging and the causes include: Increasing age directly relates to the degenerative process in the joint.Prevalence of OA is between 50% and 80% in the elderly.By 40 years of age, 90% of the population has degenerative joint changes in their weight-bearing joints.Osteoarthritis often begins with the third decade of life and peaks between the fifth and the sixth decades.
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The resulting damage predisposes to damage further as the chondrocyte is triggered to respond again.Ĭheck out this awesome pathophysiology and easy-to-understand video by Osmosis. Proteolytic enzymes, metalloproteases, and collagenase are stimulated, produced, and, released. After the chondrocyte response, the release of cytokines occurs. Factors that initiate chondrocyte response include previous joint damage, genetic and hormonal factors, and others. OA starts from an injury of the articular cartilage, subchondral bone, and synovium. Osteoarthritis may be thought of as the result of many factors that, when combined, predispose the patient to the disease.
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Osteoarthritis (OA) is the most frequently disabling among joint disorders. Learn about the nursing care management of patients with osteoarthritis in this nursing study guide.