Osteoarthritis (OA) is the most common rheumatic disorder afflicting humankind and vertebrates in general. The most common alternative terms, osteoarthrosis and degenerative joint disease, are used because of divergent concepts of the nature and cause of the disorder. One school maintains that OA is a family of systemic inflammatory disorders with similar clinical and pathological end results. Another supports the use of the term "osteoarthrosis" because inflammation is not present. Still another uses the term "degenerative joint disease" because it is held that aging and "wear and tear" are responsible for its occurrence.
William Heberden, an eighteenth-century English physician, gained immortality by describing what we now term Heberden's nodes, a common heritable form of osteoarthritis, especially common in women. In his Commentaries, he writes:
What are those little hard knots, about the size of a small pea, which are frequently seen upon the fingers, particularly a little below the top, near the joint? They have no connection with the gout, being found in persons who never had it: They continue for life; and being hardly ever attended with pain, or disposed to become sores, are rather unsightly, than inconvenient, though they must be some little hindrance to the free use of the fingers (Heberden 1802)
Modern research provides new data for a comprehensive definition encompassing clinical, biochemical, and anatomic features (Denko 1989). OA is a multifactorial systemic inflammatory disorder with clinical symptoms of pain and stiffness in movable joints, showing radiographic evidence of cartilage loss and bony overgrowth. The anatomic changes -cartilage loss and a kind of bony overgrowth and spurs-may occur physiologically without clinical symptoms. Osteoarthritis is classified as primary (idiopathic) when there is no known predisposing factor; or secondary, when there is a clearly defined, underlying condition contributing to its etiology, such as trauma, metabolic diseases, or gout. Several symptom complexes are grouped as variant subsets such as generalized osteoarthritis or erosive inflammatory osteoarthritis.
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