CLASSIFICATION OF OA :
1. IDEOPATHIC
A. LOCALISED OA
* HANDS
- HEBERDENS NODES
- BOUCHARDS NODES
- EROSIVEINTERPHALYNGEAL ARTHRITIS
- 1ST CARPOMETACARPAL JOINT
* FEET
- HALLUX VALGUS
- HALLUX RIGIDUS
- CONTRACTED TOES ( HAMMER / COCK UP TOES )
- TALONAVICULAR
* KNEE
- MEDIAL COMPARTMENT
- LATERAL COMPARTMENT
- PATELLOFEMORAL COMPARTMENT
* HIP
- ECCENTRIC ( SUPERIOR)
- CONCENTRIC ( AXIAL , MEDIAL )
- DIFFUSE ( COXAE SENILIS )
* SPINE
- APOPHYSEAL JOINTS
- INTERVERTIBRAL JOINTS ( DISKS )
- SPONDYLOSIS ( OSTEOPHYTES )
- LIGAMENTOUS ( HYPEROSTOSIS, FORESTIERS DISEASE, DIFFUSE IDEOPATHIC SKELETAL HYPEROSTOSIS
* OTHER SINGLE SITES LIKE GLENOHUMORAL , ACROMIOCLAVICULAR, TIBIOTALAR, SACROILIAC, TEMPOROMANDIBULAR
B. GENERALISED OA INCLUDES3 OR MORE OF THE AREAS LISTED ABOVE
2.SECONDARY
A. TRAUMA
- ACUTE
- CHRONIC ( OCCUPATIONAL, SPORTS )
B. CONGENITAL OR DEVELOPMENTAL
1. LOCALISED DISEASES - LEGG-CALVE-PERTHES, CONGENITAL HIP DISLOCATION, SLIPPED EPIPHYSIS
2. MECHANICAL FACTORS - UNEQUAL LOWER EXTREMITIES LENGTH, VALGUS / VARUS DEFORMITY , HYPERMOBILITY SYNDROMES
3. BONE DYSPLASIAS - EPIPHYSEAL DYSPLASIA, SPONDYLOEPIPHYSEAL DYSPLASIA, OSTEONYCHONDYSTROPHY
C. METABOLIC
- OCHRONOSIS ( ALKAPTONURIA )
- HEMOCHROMATOSIS
- WILSONS DISEASE
- GAUCHER DISEASE
D. ENDOCRINE
- ACROMEGALY
- HYPERPARATHYROIDISM
- DIABETES MALLITUS
- OBESITY
- HYPOTHYROIDISM
E. CALCIUM DEPOSITION DISEASE
- CALCIUM PYROPHOSPHATE DIHYDRATE DEPOSITION
- APATITE ARTHROPATHY
F. OTHER BONE & JOINT DISEASES
- LOCALISED LIKE FRACTURES, AVASCULAR NECROSIS, INFECTION, GOUT
- DIFFUSE LIKE RHEUMATOID ARTHRITIS ( INFLAMMATORY ) , PAGETS DISEASE, OSTEOPETROSIS, OSTEOCHONDRITIS
G. NEUROPATHIC ( CHARCOT JOINT )
H. ENDEMIC
- KASHIN-BECK
- MSELENI
I. MISCELLANEOUS
- FROSTBITE
- CAISSONS DISEASE
- HEMOGLOBINOPATHIES
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DIFFERENTIAL DIAGNOSIS:
β’ Distinguish from other types of arthritis by absent systemic findings, minimal articular infl ammation, and distribution of involved joints (e.g., distal and proximal interphalangeal joints, not wrist and metacarpophalangeal joints)
β’ In spine, distinguish from osteoporosis, metastatic disease, multiple myeloma, other bone disease
X-RAY JOINTS -
* NARROWING OF JT. SPACES, SUBCHONDRAL SCLEROSIS, SUBCHONDRAL CYSTS, OSTEOPHYTES, DEFORMITY.
* ARTHROSCOPY
* SEROLOGY - NORMAL