Issue 9/2022
R. Nestorova, Tz. Petranova, I. Sheytanov
A brief review is presented with current data on epidemiology, risk factors, pathogenesis, clinical signs, imaging and treatment of the most common degenerative joint disease-osteoarthritis (OA). Emphasis is placed on the fact that inflammatory mediators are located in all joint tissues- synovial fluid, synovial membrane, subchondral bone and cartilage. The initiation and maintenance of the inflammatory process in OA is governed by various pro-inflammatory cytokines such as Interleukin 1β, Tumor necrosis factor-α, Interleukin-6 and Interleukin-17, which act synergistically in the release of inflammatory mediators from OA-induced joint tissues.
The most typical in clinical picture is absence of symptoms in the initial stage of the disease. Later, the main symptom is pain, which is of a mechanical type (increases with physical exertion and decreases with rest). Other common symptoms of the affected joint are swelling and limited range of motion.
Diagnosis of OA is based on imaging methods as Radiography, Musculoskeletal Ultrasound and Magnetic Resonance Tomography. There is no proven effective disease-modifying therapy for OA to be recommended by world and European guidelines. It relies on a complex therapeutic approach that concerns symptomatology, improves joint function and reduces the frequency of OA activation. It is based on patient training, symptomatic treatment, chondroprotection, methods of physical medicine, and surgical treatment in the last stage of the disease. Main representatives of chondroprotective therapy and methods of application are reviewed.
Address for correspondence:
R. Nestorova, Rheumatologist
„Saint Irina” Rheumatology Center – Sofia
j.k. Poligona, bl. 43, floor 1, office 2
1750, Sofia, Bulgaria
tel.: +359 888 813 435