Normal Joint:
Cartilage is the smooth surface covering the ends of the bones in a normal joint.
It allows the bones to move freely against each other and acts as a cushion.
The joint is surrounded by a Capsule. Thickenings of the capsule are called Ligaments
and they provide stability to the joint.
The Synovium is a layer of tissue on the inside of the capsule. The synovium produces
fluid which lubricates the joint and provides nutrition to the cartilage. Only a tiny amount
of fluid is present in a normal joint ( eg 1/2ml in a knee).
Osteoarthritis:
Arthritis literally means inflammation of a joint. There are more than a 100 different
types of arthritis. Osteoarthritis is “old age” or “wear and tear” arthritis.
It involves the degeneration of the cartilage in the joint and eventually results in
bones rubbing against bones.
There is no cure for arthritis. It can be “managed” with drugs and other therapies
but like the treatment for High Blood pressure it is not curative.
Osteoarthritis may follow an injury but usually is genetically based and runs in families.
It affects the end joints of the fingers ( Bony swellings called Heberden's Nodes ) and the
basal thumb joint.
It typically results in pain with activity. Over time the pain fluctuates and may reduce as
the joint gets stiffer.
Blood tests are normal in osteoarthritis.
Normal Joint Osteoarthritis
Treatment of Osteoarthritis:
- Rest, Fish oil , Diet
- Panadol occasionally
- Panadol Regularly
- NSAIDS – “anti-inflammatories” – beware irritation of stomach. Always take with food.
- Heat packs
- Exercises to retain range of movement and muscle tone.
- Splints
- Cortisone injections
- Surgery:
– Arthroscopy
- Arthroplasty – replacing the basal thumb joint with tendon
- Arthrodesis – fusing or permanently stiffening a joint to remove the arthritis.
- Glucosamine – No credible evidence that this makes a longterm difference in osteoarthritis
Revised 20 / 4 / 2015