LAMEZIA TERME “Osteoarthritis causes symptoms that are worsening, that is, destined to worsen over the course of life, to determine ever greater functional disabilities and ever greater recourse to medical and specialist treatments”. So Dr. Riccardo Maschio, medical director in the Orthopedics and Traumatology department of the Giovanni Paolo II Hospital in Lamezia Terme, guest of the last episode of “Health and Health“, the format of The other TV Courier, which aired last night. Symptoms and therapies against osteoarthritis, also commonly known as arthrosis, the differences with arthritis and ways to prevent a degenerative disease that affects about 10% of the general population and 50% of the population over 60 years of age. These are the topics addressed during a rich episode, during which we also focused on another pathology, osteoporosis which often affects the elderly and which determines the bone fragility that causes the fracture of the femur.
What is osteoarthritis
Osteoarthritis, also commonly known as osteoarthritis, is a degenerative disease that affects about 10% of the general population and 50% of the population over 60 years of age. “It’s the typical pathology of aging, but not only,” Maschio said in response to Soave Pansa’s questions. “There are different forms of osteoarthritis – added the specialist – and it determines symptoms that are worsening, that is, destined to worsen over the course of life, to determine ever greater functional disabilities and ever greater recourse to medical and specialist treatments”. Primary and secondary osteoarthritis can be distinguished: «the primary one is the form that also affects young adults aged 40 to 50, it is located in the joint that is used the most and normally affects genetically predisposed subjects. The secondary one, the degenerative pathology typical of the elderly, affects the joints most subjected to the load: the knees, the hips, the joints of the spine, in particular at the level of the joints and the lumbar girdle and also at the level of the cervical joint ».
How does it manifest itself?
Among the main manifestations is pain. «Slowly – explained Dr. Maschio also manifests itself with joint stiffness, with functional impotence of variable degree. The pain can be a morning pain, upon awakening, which gradually decreases as the subject carries out his daily activities. Within about twenty minutes, in the initial stages of arthrosis, the pain located in a knee and a hip is attenuated in the initial stages. Subsequently the pain becomes more prevalent, more oppressive, because it lasts all day and occurs in conjunction with the use of that joint.
Osteoarthritis and arthritis. «To distinguish them you need to pay attention to some peculiar characteristics»
The differences with arthritis are subtle but significant: «Often arthrosis and arthritis are confused. It is a very common error due to a similarity of terms. It is very complex – explains the specialist – to make a diagnosis of arthritis compared to that of arthrosis. From the symptomatological point of view, they sometimes have a similar onset, but attention must be paid to some peculiar characteristics ». «When a pathology affects small joints for no apparent reason, it begins quite rapidly, with localized swelling, pain and redness in the wrists, fingers, at the level of the phalanges with deformities in some cases also in the joints, then we must ask our doctor about basis which gives us a series of analyses. The competence then is particular, in part it belongs to the orthopedist, in part it then passes to the rheumatologist ».
Diagnosis and prevention
«Early diagnosis of a form of arthritis must be treated with systemic therapy in such a way that it does not degenerate. The diagnosis of osteoarthritis – the specialist explained – is essentially based on radiographic imaging. The classic x-ray tells us a lot about a joint and the degree of damage to the joint. Once we have established that the patient is suffering from arthrosis, we go to find a targeted treatment for that patient. In fact, there are different approaches also depending on the stage in which arthrosis is diagnosed. In the initial phase of arthrosis the approach is varied and multidisciplinary, while in the acute phase either the general practitioner or the orthopedic specialist intervenes. In some cases it is then necessary to go to second level diagnostics, such as magnetic resonance which can make us a study on the cartilage. Initially there is an anti-inflammatory pharmacological approach to resolve the symptomatological situation. Once this is done, we need to see what the cause of the osteoarthritis is. It may be due to various causes.” The lifestyle also affects the development of the disease, in fact it is essential for prevention. It is important “to pay attention to body weight, to avoid certain efforts and even certain sports, but physical activity is essential”.
The therapies
«Today we orthopaedists – explained the specialist – are very often called upon to treat osteoarthritis with infiltrations, the so-called intra-articular infiltrations. By practicing the infiltration already two or three days later, the patient acquires a new function and loses the painful symptoms. Hyaluronic acid gives excellent answers. Today, pharmaceutical companies put a very important weapon in our hands that allows us to control both the symptoms and the evolution of the pathology. It is precisely for this reason that we must stage arthrosis, because knowing at what stage we are not going to intervene, we must choose the appropriate hyaluronic acid for our patient. Not all hyaluronic acids are the same, not all are superimposable». Treatments that are practiced regularly at the John Paul II hospital.
The fracture of the femur
Finally, during the episode we also focused on another pathology, osteoporosis, which often affects the elderly and which determines the bone fragility that causes the fracture of the femur. «It is one of the main pathologies treated by the orthopedic surgeon in a hospital environment. We have – explained Dr. Maschio – about 60-70% of our patients who are hospitalized throughout Italy for a fracture of the proximal femur, it is a typical pathology of the elderly because it is a pathology of bone fragility which is determined by the osteoporosis, which is a form of degeneration not of the cartilage, but of the internal structure of the bone». Fractures that are treated in almost all cases surgically and which allow patients to get back on their feet within a few days, “is very important in elderly patients”, explained the specialist.