Erosive Osteoarthritis

What is Erosive Osteoarthritis?

Erosive (also known as inflammatory) osteoarthritis is a less typical, but considered a subtype of osteoarthritis.  Like all forms of osteoarthritis, we’ll see degeneration of the cartilages (especially affecting the hands). However, there will also be inflammation in erosive osteoarthritis – the joints will be swollen, stiff and tender, therefore being easily confused with rheumatoid or psoriatic arthritis.

More Details about Erosive OA

This form of OA is found to be more prevalent in women than men (12: 1 ratio), especially affecting the middle and post-menopausal women. The most affected joints are the small joints of the fingers, although other joints may also have signs of inflammation. The x-ray will show typical erosions called “gull wing" deformities.  Lab tests reveal rheumatoid factor negative (which will help the doctors rule out rheumatoid arthritis).

The exact cause of erosive osteoarthritis is not known, although hormones, metabolic disorders and autoimmune reactions may play a role. One study featured in the “Annals of the Rheumatic Diseases" reveals that individuals with erosive OA of the hand had more than twice the risk of metabolic syndrome (a cluster of conditions that include high blood pressure, high blood sugar levels, excessive body fat around the waist and abnormal levels of cholesterol) and more than four times the risk of dyslipidemia (characterized by either abnormal cholesterol and or triglycerides, or low HDL cholesterol levels) compared with those who don’t have this condition.

The treatment of erosive OA includes physical therapy, non steroid anti-inflammatory drugs (NSAIDs) and prednisone. Some cases (when the joint destruction is significant) will require surgery.

Despite the symptoms, the prognosis is generally good, as many patients will experience remission of the symptoms over time. The joints will still be affected by degeneration, but without inflammation, similarly with the typical OA.

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Tips to Better Manage Erosive OA

  1. Make sure you get the right diagnosis, because this condition can be easily misdiagnosed. See your doctor and complete all the necessary tests to rule out other inflammatory arthritis such as rheumatoid arthritis or psoriatic arthritis. It is really important to receive the correct diagnosis because the treatment of erosive OA is different –for example the anti-RA drugs such as methotrexate or leflunomide prescribed for RA are not appropriate for erosive OA.
  2. Work with your physiotherapist and get an individualized fitness plan. Exercise can improve the strength of the muscles around the affected joints, and keep your joints mobile and flexible. However, if you feel a new joint pain while working out you should stop and rest. Try yoga and tai-chi – they are gentle on your joints and studies found these technique beneficial to improve OA pain.
  3. Eat a healthy diet. Highly processed foods are high in sugar, saturated fats and artificial additives, which promote inflammation in the body. Focus on fresh fruits and vegetables, whole grains, beans, legumes, nuts and seeds, as well as healthy oils, fish and lean meats.
  4. Use heated pads (help to relive stiffness) and cold pads (for muscle spasms and pain).
  5. Consider assistive devices (i.e. gripping and grabbing tools in the kitchen) to make your cooking easier on your joints.
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