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).

Note:

  • Cartilaginous calcification is seen with OA; however, it is thought to be due to aging.[6]

Images

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Hip

FEMORAL HEAD, RIGHT, HIP ARTHROPLASTY: 
- DEGENERATIVE JOINT DISEASE.

FEMORAL HEAD, RIGHT, HIP ARTHROPLASTY: 
- OSTEOARTHRITIS.

Knee

SYNOVIUM, LEFT KNEE, BIOPSY:
- SYNOVIUM WITH MILD CHRONIC INFLAMMATION AND VILLOUS HYPERPLASIA -- COMPATIBLE 
 WITH OSTEOARTHRITIS.

Micro

The sections show thinned cartilage composed of chrondrocytes clusters separated by vertical fibrous septa. The deep aspect of the cartilage is basophilic. An osteophyte is present.

The soft tissue shows a minimal, focal chronic inflammatory cells.

Note:

  • Noninflammatory degenerative joint disease is the term used by the ICD.[10]

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. ↑ Mitsuyama, H.; Healey, RM.; Terkeltaub, RA.; Coutts, RD.; Amiel, D. (May 2007). "Calcification of human articular knee cartilage is primarily an effect of aging rather than osteoarthritis.". Osteoarthritis Cartilage 15 (5): 559-65. doi:10.1016/j.joca.2006.10.017. PMID 17276093.
  7. ↑ URL: http://www.medpath.info/MainContent/Skeletal/Joint_02.html. Accessed on: 10 November 2012.
  8. ↑ URL: http://www.med.nyu.edu/medicine/labs/abramsonlab/basic-arth-research.html. Accessed on: 10 November 2012.
  9. ↑ URL: http://www.medic.usm.my/~pathology/bonepath/bonepath/Osteoathritis.html. Accessed on: 22 November 2012.
  10. ↑ URL: http://www.icd9data.com/2012/Volume1/710-739/710-719/715/715.9.htm. Accessed on: 15 March 2013.
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