Arthrosis or osteoarthritis is a disease that occurs due to aging and wear and tear of the joints, which mostly affects the joints that more frequently subjected to heavy load, i.e. the hips, knees and spine; more rarely, it can also affect the joints of the hands and feet. The most common symptoms of osteoarthritis are pain, stiffness and restriction in the use of the joint. Symptoms begin to appear around the age of 50, especially in female patients after menopause.

What is osteoarthritis?

Osteoarthritis is a disease that occurs due to wear and tear and aging of the joints, which mainly affects joints that are frequently subjected to heavy load, that is, the knees and the spine, but more rarely it can also affect the joints of the hands and feet. 

Osteoarthritis is caused by the deterioration of the cartilage that covers the bone surfaces within joints. Cartilage is a tissue that reduces friction between the bones and when it is damaged by wear and tear, it loses its elasticity, becomes more rigid and more easily damaged. In addition to the deterioration of cartilage, tendons and ligaments become inflamed, causing pain. If the condition worsens bones may get to rub against each other causing pain, swelling and stiffness, and bone spouts called "osteophytes" can also occur, typically on the hands. 

The symptoms of osteoarthritis start to appear around the age of 50, especially in female patients after menopause. Prior to that arthrosis affects men and women equally, and the causes may be more work-related or due to lifestyle and hormonal changes associated with menopause.

What causes arthrosis?

Osteoarthritis is a disease linked to aging and wear and tear of articular cartilage, which can be supported by factors such as:

• Family history
• Being overweight and obesity: excess weight in the long run harms the joints of the hip, knee and foot
• Fractures and joint injuries
• Some jobs that require forced positions (kneeling long) or the continued use of certain joints (e.g. the joints of the fingers)
• Sports like football: where there is premature wear and tear of the cartilage of the feet and knees
• Circulatory diseases that cause bleeding and damage in the joints (e.g. haemophilia, avascular osteonecrosis)
• Some forms of arthritis (e.g. gout, pseudo gout or rheumatoid arthritis) that damage the articulation and make it more susceptible to cartilage damage.

What are the symptoms of osteoarthritis?

The most common symptoms of osteoarthritis are pain, and stiffness and restriction in the use of the affected joint.

The pain experienced is mechanical, i.e. increased after exercise or when you load weight over the affected joint; usually the pain is more intense at night and it is relieved by rest. Often at the beginning of movements one can hear the articulation and noises called joint "bursts". Not all patients with osteoarthritis experience these symptoms; osteoarthritis often becomes evident only by performing an X-ray.

Some specific aspects of osteoarthritis are those affecting the hands. It can often affect a strain of the small joints of the fingers: the "nodules of Heberden" affecting the distal joints (end) of the fingers, while the "nodules of Bouchard" develop at the level of the proximal joints of the fingers. Both types of nodules can be painful when they are formed, also causing a restriction on movement.

On the other hand, osteoarthritis of the spine can lead to the formation of osteophytes that protrude from the vertebrae, causing irritation of certain nerves and therefore pain, tingling and numbness in some areas of the body.

Diagnosis

The diagnosis is based on several elements, including:

• The medical examination, which assesses whether the joints are deformed, painful, and limited in performing certain movements;
• The radiological investigations, which show for example a reduction in the space between the joints, change in the profile of the bone and the formation of osteophytes or cyst-like lesions of the joints.

There are no specific laboratory tests for the diagnosis of osteoarthritis, which at times is a diagnosis of exclusion.