ANSWER
Case Study: Osteoarthritis (OA)
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Case Study: Osteoarthritis (OA)
OA is A Disease of Articular Cartilage and Subchondral Bone in Diarthrodial Joints
Osteoarthritis is a degenerative joint disease characterized by the destruction of the cartilage, a smooth and elastic covering of the end of bone surfaces in diarthrodial joints that allows for easy movement (Abramoff & Caldera, 2020). The destruction tends to extend and involves the subchondral bone immediately beneath the cartilage covering. This is the hallmark in the development of osteoarthritis, in which the damaged subchondral bone wears down over time, becomes painful, stiff, and with limited range of motion.
Role of Osteophytes in OA
Osteophytes, also referred to as bone spurs, are outgrowths of bones forming around the margins of affected joints in OA (Roelofs et al., 2020). They develop as a response by the body to repair the damage, forming new bone tissue. However, this can create more issues, as these osteophytes can cause more pain and stiffness as they tend to impinge various structures, such as nerves, vessels, and even tendons that pass within that localization (Roelofs et al., 2020).
How NSAIDs Affect OA
NSAIDs are some of the drugs used in the management of OA, as it helps in providing symptomatic relief. It works by stopping the process of inflammation by inhibiting the cyclooxygenase (COX) enzymes which play a vital role in inflammation and the production of inflammatory mediators such as prostaglandins, which are responsible for the pain and swelling (Magni et al., 2021). By blocking this enzyme, there is reduced inflammation, which subsequently provides symptomatic relief. However, the user should be monitored to avoid adverse side effects such as gastrointestinal bleeding (Magni et al., 2021).
How Weight Loss Affects OA
Being overweight or obese is one of the risk factors for the development of OA. Therefore, weight loss helps reduce the load on the various weight-bearing joints, such as the knee (Messier et al., 2018). Such weight reduction, therefore, slows the speed of cartilage breakdown, which can help provide symptomatic relief and slow the disease’s progression (Messier et al., 2018). In addition, weight loss also helps prevent comorbidities, such as diabetes which further increases the likelihood of developing osteoarthritis.
References
Abramoff, B., & Caldera, F. E. (2020). Osteoarthritis: pathology, diagnosis, and treatment options. Medical Clinics, 104(2), 293–311. https://www.medical.theclinics.com/article/S0025-7125(19)30113-0/abstract
Magni, A., Agostoni, P., Bonezzi, C., Massazza, G., Menè, P., Savarino, V., & Fornasari, D. (2021). Management of osteoarthritis: expert opinion on NSAIDs. Pain and Therapy, 1-26. https://link.springer.com/article/10.1007/s40122-021-00260-1
Messier, S. P., Resnik, A. E., Beavers, D. P., Mihalko, S. L., Miller, G. D., Nicklas, B. J., … & Loeser, R. F. (2018). Intentional weight loss in overweight and obese patients with knee osteoarthritis: is more better? Arthritis care & research, 70(11), 1569-1575. https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23608
Roelofs, A. J., Kania, K., Rafipay, A. J., Sambale, M., Kuwahara, S. T., Collins, F. L., … & De Bari, C. (2020). Identification of the skeletal progenitor cells forming osteophytes in osteoarthritis. Annals of the rheumatic diseases, 79(12), 1625-1634. https://ard.bmj.com/content/79/12/1625.abstract
QUESTION
Case Study
A 65-year-old male presents with a painful left finger, he is unable to bend it and it is significantly swollen. He has a history of osteoarthritis.
- OA is a disease of articular cartilage and subchondral bone in diarthrodial joints. Explain this.
- What is the role of osteophytes in OA?
- How do NSAIDS affect OA?
- How does weight loss affect OA?