Osteoarthritis: The disease process
Deterioration of Cartilage. Osteoarthritis develops when cartilage in a joint deteriorates. The process is usually slow:
To compound the process, bone around the arthritic joints is not structurally normal. Problems most likely develop in
the bone as the body tries to repair damage to the cartilage are:
- In the early stages of the disease the surface of the cartilage, or even the synovium in some people, becomes inflamed and swollen. There is a loss of proteoglycan molecules and other tissue components that cause water loss. Fissures and pits appear in the cartilage.
- As the disease progresses and more tissue is lost, the cartilage loses elasticity and fluid. It becomes increasingly prone to damage due to repetitive use and injury.
- Eventually large amounts of cartilage are destroyed, leaving the ends of the bone within the joint unprotected.
To compound the process, bone around the arthritic joints is not structurally normal. Problems most likely develop in
the bone as the body tries to repair damage to the cartilage are:
- Clusters of damaged cells or fluid−filled cysts may form around the bony areas or near the fissures.
- Fluid pockets may also form within the bone marrow itself, causing swelling. The marrow, which runs up through the center of bone, is rich in nerve fibers and such injuries may be an important source of pain in many osteoarthritis sufferers.
- Bone cells may respond to damage by multiplying and growing and by forming dense, misshapen plates around exposed areas.
- At the margins of the joint, the bone may produce outcroppings, on which new cartilage cells (chondrocytes) proliferate and grow abnormally.
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