ARTHROSIS: THE SYMPTOMS

Clinic

Osteoarthritis is characterized by joint signs and symptoms that arise subtly, usually after the age of 40 in the male and after the age of 55 in the female.

Preferably, one or some of the following joints are affected: distal interphalangeal (between the last two phalanges) and, less frequently, proximal (between the first and second phalanxes); elbow and ankle joint; knees (particularly in females), coxofemoral (hip) joint, cervical and lumbar spine (particularly in males).

Symptoms

For further information: Arthrosis Symptoms

The main symptom is pain; it first arises only during joint movement, especially after an immobility of several hours, upon waking up in the morning or due to movements in sleep, with a stabbing character; in later stages it also appears at rest, and is deep and poorly localized, favored by previous joint abuse or by meteorological changes. The morning stiffness lasts for a few minutes, in any case less than half an hour. The limitation of movements can appear in phases of flare-up of the disease and in the advanced stages, and is due to the muscular contracture that is triggered as a defense against pain. The peripheral joints are swollen and have a hard consistency (wooden) due to the presence of osteophytes. There may be pain on palpation of the joint and its passive movement, during which a crepitus, a splash or a snap of the joint may be perceptible, due to the incongruity of the joint heads or due to the presence of free osteophytes in the joint cavity. Liquid effusion is rarely present; the joint may be hot, but the redness and swelling of the soft parts that continue with it are rare, except during periods of flare-up of inflammation.

In the late stages deformities and dislocations dominate, with deviation, ulnar or radial (in the direction of the radius or ulna), of the phalanges, of the knee (varus or valgus) and hallux valgus; usually there is no total loss of function except at the hip and wrist joints.
Particularly frequent localizations are:
Osteoarthritis of the hand: often determines the flexion and lateral deviation of the last phalanx, first to the second and fifth finger, then it becomes multiple and bilateral; in a third of cases the proximal interphalangeal joints are also involved, rarely the wrist joint.
Osteoarthritis of the hip: it can appear in the middle age or even earlier when it is secondary (60-80% of cases) to malformations, trauma, arthritis of the hip, rupture of the femoral head. The pain is acute when standing upright, or deep after a prolonged load. It can be felt along the lateral aspect of the thigh, in the groin, on the inner surface of the thigh or in the knee. It causes a limp and an abnormally oblique pelvis.
Later, a reduction in limb length, severe motor limitation and lordosis of the lumbar spine appear.
Osteoarthritis of the knee: frequent in women and in professional osteoarthritis, it causes pain in the act of kneeling, climbing stairs, getting up or sitting down. passive movement Additional symptoms include comprasa of varus or more rarely valgus, reduced flexion or extension of the leg on the thigh, or loss of ability to move the patella laterally.
Foot osteoarthritis: it first determines a bursitis (inflammation of the bursa that surrounds and protects the joint), and then the degeneration of the big toe joint, particularly subjected to load and traumas due to walking, with evolution towards rigid hallux or valgus.
Spinal osteoarthritis: the segments most affected are the lower sections of the lumbar and cervical spine, due to the greater mobility of the same spine in these locations. At the cervical level it causes pain, stiffness and crackling to movements; the osteophytes and the protrusion of the intervertebral disc (a structure that acts as a shock absorber between one vertebra and the other), cause compression of the roots of the spinal nerves, which are found to pass through these locations, causing irradiated pain to the scapula and arm, accompanied by tingling or difficulty in its movements. Arthrosis of the thoracic spine is rare in the absence of predisposing causes such as scoliosis. Lumbar, on the other hand, favored by body weight and the presence of normal lumbar lordosis, is the most common cause of lumbar and sacral pain, and can cause sciatica, with pain and tingling irradiated to the front and side of the thigh and leg.