HOW DOES THE ARTHRITIC PROCESS BEGIN?

The arthritic process

The initial triggering event may remain unknown, or it may be represented by a trauma or wear due to an abuse of the joint, or an incongruity of the joint heads due to joint diseases of various origins, or even due to vascular damage or a impaired innervation, or for endocrine causes that induce joint damage (acromegaly, Cushing, drugs with cortisone, hypothyroidism, diabetes mellitus).
The first lesion consists in a softening and a flattening in the seat of maximum support of the opposite cartilages. In this way i are activated chondrocytes, which are the cells that produce cartilage and reside there. The activation of the chondrocytes results in the accelerated formation of new collagen fibers, thinner and more disorganized than normally; moreover, they release degradative enzymes in the site: thus promoting the self-maintenance of a chronic process of modest inflammation and degradation of the cartilage structure. It, now weak, slowly fractures because the liquid that bathes it, called synovial fluid, it insinuates itself inside its ravines during joint movements, causing real "cartilaginous collapses" that expose the bone to bare, which becomes denser. Since the first period of joint pain, new bone formations called osteophytes, which develop the more the slower the course of osteoarthritis and are considered an inadequate attempt at bone repair. Microfractures, inflammation of the synovium (synovitis), which is the capsule that covers the joint, osteophytes and joint incongruity add up as causes of pain. When the degeneration is so advanced that the death of the chondrocytes and the destruction of the cartilage can no longer be balanced by the reparative capacity of the residual cells, the last stage of joint instability and destruction occurs with irreversible disability.