Fast Five Quiz: Arthritis

Herbert S. Diamond, MD


July 28, 2020

The stresses applied to the joints, especially the weight-bearing joints (eg, ankle, knee, and hip), play a role in the development of osteoarthritis. However, exercise may slow progression of osteoarthritis and delay the need for joint replacement. Most investigators believe that degenerative alterations in osteoarthritis primarily begin in the articular cartilage, as a result of either excessive loading of a healthy joint or relatively normal loading of a previously disturbed joint. External forces accelerate the catabolic effects of the chondrocytes and further disrupt the cartilaginous matrix. Trauma or surgery (including surgical repair of traumatic injury) involving the articular cartilage, ligaments, or menisci can lead to abnormal biomechanics in the joints and accelerate osteoarthritis.

Risk factors for osteoarthritis include the following:

  • Age

  • Obesity

  • Trauma

  • Genetics (significant family history)

  • Reduced levels of sex hormones

  • Muscle weakness

  • Repetitive use (eg, jobs requiring heavy labor and bending)

  • Infection

  • Crystal deposition

  • Acromegaly

  • Previous inflammatory arthritis (eg, burnt-out RA)

  • Heritable metabolic causes (eg, alkaptonuria, hemochromatosis, Wilson disease)

  • Hemoglobinopathies (eg, sickle cell disease, thalassemia)

  • Neuropathic disorders leading to a Charcot joint (eg, syringomyelia, tabes dorsalis, diabetes)

  • Underlying morphologic risk factors (eg, congenital hip dislocation, slipped femoral capital epiphysis)

  • Disorders of bone (eg, Paget disease, avascular necrosis)

  • Previous surgical procedures (eg, meniscectomy)

  • Diabetes mellitus

Read more about risk factors for osteoarthritis.


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