Degenerative Joint Disease Pathophysiology

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Degenerative joint disease affects approximately 27 million Americans. In this lesson, we will learn more about degenerative joint disease and how it occurs.

Degenerative Joint Disease

Sally is 65 years old and has noticed as she has gotten older she is having more stiffness and pain in her knees. Five years ago she could ignore it and continue to do her every day activities. But now she is noticing she is really stiff when getting out of bed in the morning and it takes her at least 30 minutes to really get moving. She is having more pain and is now having to take acetaminophen several times a day to be able to get her housework done. She decides to go and see her doctor, and after examination and X-rays, he tells her that she has primary osteoarthritis.

Degenerative joint disease (DJD) is a form of arthritis. It is also commonly called osteoarthritis or even degenerative arthritis.

There are over a hundred types of arthritis and DJD is the most common. The occurrence of DJD increases as we age. Before the age of 45 osteoarthritis is more common in males and after the age of 45 it is more common in females.

There are two types of osteoarthritis. Primary osteoarthritis is when there is no known cause. Secondary osteoarthritis is when there is a known cause, such as an injury or surgery that led to the arthritis.

Pathophysiology

Sally doesn't have any medical experience and although she has heard the word arthritis before, she tells her doctor that she really doesn't understand what this is and why she has it. Her doctor proceeds to explain it to her.

DJD most commonly affects the joints in the hands, feet, spine, hips, and knees. It's important to understand how our joints work. A joint is a moving, bending part of our body and has two bones that come together. Between those two bones is cartilage, which is a gelatinous type material that is firm but slippery to allow the two bones to easily glide over each other when they are moving. It also works like a shock absorber for the joints.

Anatomy of a Joint
joint

As we age, or if we have an injury, the cartilage begins to become more stiff. When the cartilage is stiff, it is more vulnerable to damage and begins to wear down. Eventually the cartilage wears away to the point that the bones no longer have their shock absorber and are now rubbing together with movement. You may have heard people use the term 'bone on bone'--this is what they are referring to.

Symptoms

Sally demonstrated classic symptoms of osteoarthritis. Stiffness of the joint, especially after inactivity, is common. Pain is another classic symptom she was experiencing. Other symptoms include the sound or feel of bones grinding with movement, development of knobby joints in the fingers, and bone spurs. Bone spurs are growths of bone in the joint that may break off and float around in the joint, leading to even more severe pain.

Risk Factors

Some of the risk factors for developing DJD include aging and gender, as we discussed earlier. Genetics can make you more prone to get DJD, as can congenital defects that may affect the joints. Obesity and injuries also increase the likelihood of developing DJD.

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