Osteoarthritis: the cause not result of joint failure?

Article Abstract:

Osteoarthritis is a chronic disease characterized by destruction of joint cartilage, and overgrowth, malformation, and impaired function of the bone. The disease may result from various types of injury to the joint, and commonly affects certain joints, including those in the first toe, hands, fingers, knee, and spine. The joints in the wrist, elbow, shoulder, ankle, and other toes are rarely affected. The mechanisms that cause osteoarthritis have not been clarified, although the disorder is associated with both the destruction and overgrowth of the joint. It is possible that various factors directly cause joint malfunction, triggering osteoarthritic processes which lead to joint failure. The growth of the joint may be an attempt to repair the destructive processes. Alternately, it is possible that the normal mechanisms controlling joint growth may be adversely affected, resulting in osteoarthritic changes and joint malfunction and failure. In order for the second mechanism, the breakdown of normal growth control regulation, to occur, certain conditions are necessary: the joint needs to be able to grow; features of osteoarthritis must reflect normal tissue growth processes; and a failure of controlling systems must be evident. Several lines of evidence that are consistent with these criteria or conditions are discussed. Thus, osteoarthritis may result from the breakdown of the normal mechanisms controlling the growth of the joint. (Consumer Summary produced by Reliance Medical Information, Inc.)

Joint diseases

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Premature development of erosive osteoarthritis of hands in patients with chronic renal failure

Article Abstract:

Osteoarthritis is a very common noninflammatory progressive arthritis, chiefly of weight-bearing joints, but also of the terminal finger joints. Studies have found occurrences of osteoarthritis in patients with kidney disease, but whether this was more related to age or disease has been unclear. Approximately 100 kidney disease patients undergoing long-term dialysis or having had kidney transplants were studied to determine if there was indeed an association. The prevalence of advanced grades of osteoarthritis was significantly higher (9.4 percent) in patients with kidney disease than in healthy people (3.0 percent). There were fewer older (over 65 years) people with kidney disease, and this group was not different from the control population. There was an increase in osteoarthritis in every decade of age above age 24. All patients with osteoarthritis had involvement of terminal finger joints, and this had extended to other finger or hand joints in some patients. The results suggest that osteoarthritis occurs at an earlier age in patients with chronic renal failure, with quick progression to severe disease. A question remains as to whether osteoarthritis associated with kidney disease is similar to other forms. The cause of the arthritis in kidney patients remains unclear, but metabolic bone disease associated with kidney failure may be involved. (Consumer Summary produced by Reliance Medical Information, Inc.)

Chronic kidney failure

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Osteoarthritis and magnetic resonance imaging: potential and problems

Article Abstract:

Magnetic resonance imaging (MRI) holds great promise in increasing understanding of osteoarthritis, and it has the major advantage of allowing investigation noninvasively and without the risks of repeated exposure to X rays. However, current understanding of the relationship between image and pathology is in its infancy, and technical obstacles in obtaining high resolution images of bone and tendon must be resolved. At present, MRI permits an analysis of the progression of the disease as it affects tendons and ligaments, cartilage, and bone marrow. In the future, MRI has the potential of enabling researchers to gather information about tissue perfusion and the diffusion of substances throughout the joints and of providing detailed analysis of small areas. Unfortunately, a shortage of funds is hampering further development of these applications of the technology.

Diagnosis, Magnetic resonance imaging

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