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Causes and risk factors of osteoarthritis

In osteoarthritis, the destruction of the cartilage corresponds to a cracking of the surface towards the depth of the cartilaginous tissue. This cracking is related to mechanical phenomena, but it is also favored by biochemical alterations of the cartilage structure.

Schematically, we can consider that osteoarthritis is the result:

Abnormal physical stresses on normal cartilage;
Normal physical stresses on abnormal cartilage;
From the conjunction of the two previous situations.

The main suspected risk factors are:

General: age, weight, menopause, other rheumatism (chondrocalcinosis, Forestier hyperostosis ...);
Genetics: the concept of familial osteoarthritis is well proven for arthrosis of the knee, hip and hand;
Local :
Significant or weak trauma to repetition (hard work, violent sports, meniscus lesions ...);
Abnormal position of the joint (scoliosis, malformation of the hip, ...);
Other localized bone or joint diseases (sequelae of arthritis, sequelae of fractures, Paget's disease ...).

At the origin of osteoarthritis are many factors that are often still poorly understood. However, the genetic character of the condition appears to be predominant. There are families of osteoarthritis and the disease affects women more often than men. For example, if some occupations (forced labor) are more exposed to osteoarthritis than others, not all members of this occupation will develop osteoarthritis (in part based on their genetic predisposition).

Screening for congenital joint abnormalities, followed by correction in childhood, is of paramount importance to prevent the onset of painful osteoarthritis in adulthood.

Obesity (or simple overweight) is undoubtedly a factor favoring the appearance of osteoarthritis in the hips and especially the knees.

To learn more, read our article on risk factors for osteoarthritis.
The symptoms of osteoarthritis

The signs of osteoarthritis vary according to the joint concerned. However, in all cases, the main reason for consultation is pain associated with functional impairment.

The pain is, in principle, called "mechanical" because it has the following characteristics:

It is triggered and aggravated by movement;
It ceases or diminishes more or less completely when the joint is at rest;
It is less important in the morning, then increases during the day and is highest in the evening;
It usually hinders falling asleep, but can also lead to nocturnal awakenings (about 50% of osteoarthritis patients are woken at night by their pain);
It reappears each time the affected joint is subjected to an effort: walking for osteoarthritis hip, climb a stair for the knee, lift the arm for the shoulder ...

Functional discomfort is a limitation of mobility of the joint affected by osteoarthritis. It is variable according to the activity of the patient. Thus, a golf player will be much more embarrassed by osteoarthritis of the knee than a subject not practicing any sport. Just as a pianist will be very handicapped by even slight osteoarthritis of the fingers.

The osteoarthritic joints are, in principle, neither red nor hot. They can be swollen when a fluid effusion (effusion of synovium) is established, which is particularly common in the knees. However, periods of inflammatory growth exist and there would be an inflammatory component in this disease, different and less important than that of rheumatoid arthritis.
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