Arthrosis

Arthrosis, also called degenerative joint disease, is a progressive condition in which the protective articular cartilage wears down and the adjacent bone and soft tissues remodel. It most commonly affects weight-bearing joints such as the knees and hips but can involve the hands, spine, and other joints.

Pathophysiology involves cartilage erosion with fissuring and thinning, exposure of subchondral bone, and bone remodeling including osteophyte formation. Synovial inflammation may occur, and altered joint mechanics contribute to pain and reduced mobility.

Risk factors include advancing age, obesity, prior joint injury, repetitive joint stress, and genetic predisposition. Female sex and certain occupations may increase risk for specific joints.

Symptoms include joint pain that worsens with activity, morning stiffness lasting less than 30 minutes, reduced range of motion, swelling, and crepitus.

Diagnosis is clinical and supported by imaging. X-rays typically show joint space narrowing, osteophytes, and subchondral sclerosis; MRI can assess early changes or subtle involvement. Blood tests help exclude inflammatory or autoimmune arthritides.

Treatment focuses on symptom relief and function. Nonpharmacologic measures include regular low-impact exercise, weight management, physical therapy, and bracing. Medications include acetaminophen and nonsteroidal anti-inflammatory drugs, topical agents, and intra-articular corticosteroids. In some joints, hyaluronic acid injections are used. Advanced disease may require surgical options such as osteotomy or joint replacement.

Prognosis is variable; arthrosis is chronic and currently incurable, but symptoms can be controlled with multidisciplinary care and appropriate interventions.