Primary osteoarthritis (OA type 1) is the most common form of degenerative joint disease that occurs due to aging without secondary causes such as trauma or systemic disease. This article aims to describe the clinical and radiological characteristics of primary OA, especially in the knee and hip joints, and to review the risk factors and diagnostic approaches used in orthopaedic clinical practice.
Get to Know What Osteoarthritis Is
Osteoarthritis (OA) is a degenerative joint disease, the damage caused can be seen with progressive destruction of articular cartilage, subchondral sclerosis, osteophyte formation, and synovial changes. Primary OA (or type 1 OA) occurs without a clear cause and is generally related to age, genetics, mechanical load, and hormonal status. The prevalence of OA increases with age and is one of the main causes of disability in the elderly population.
Clinical Characteristics
In the early stages, osteoarthritis can cause complaints such as pain and stiffness in the joints. These symptoms tend to worsen gradually and can interfere with the sufferer's ability to carry out daily activities. Here's more:
1. Main Symptoms
- Joint pain : Especially during activity, relieved by rest.
- Stiffness : Especially in the morning (<30 minutes="" span="">
- Decreased function : Difficulty walking, squatting, or climbing stairs.
- Crepitus : A "creaking" sensation during joint movement.
- Joint enlargement : Due to osteophyte formation and synovial effusion.
2. Most Frequent Locations
- Knee joint (gonarthrosis)
- Hip joint (coxarthrosis)
- Distal and proximal interphalangeal joints of the hand
3. Clinical Risk Factors
- Advanced age (>50 years)
- Female gender (especially postmenopausal)
- Obesity
- Family history of OA
- Heavy or repetitive activity
Radiological Characteristics
Diagnosis can be done with conventional radiography (X-ray). The severity of OA is usually classified using the Kellgren–Lawrence classification , which is an important reference in determining the stage and treatment of patients.
1. Typical Radiographic Findings:
- Joint space narrowing (asymmetry, usually in the medial compartment of the knee)
- Subchondral bone sclerosis
- Marginal osteophyte
- Subchondral cyst
- Deformity of joint shape (in advanced stages)
2. Radiological Scoring (Kellgren-Lawrence):
- Grade 0 : Normal
- Grade 1 : Minimal osteophytes
- Grade 2 : Osteophytes and mild joint space narrowing
- Grade 3 : Moderate narrowing, multiple osteophytes, and mild sclerosis.
- Grade 4 : Severe narrowing, bone deformity, and extensive sclerosis.
Differential Diagnosis
- Secondary OA due to trauma, rheumatoid arthritis, gout
- Avascular necrosis
- Joint infection
When to See a Doctor?
Primary osteoarthritis is a progressive degenerative condition with typical clinical symptoms and radiological findings that support the diagnosis. Early detection is important to prevent a decrease in the patient's quality of life. A thorough physical examination and plain radiography are still the mainstays in the evaluation of type 1 OA, especially in the elderly and high-risk population.
See a doctor immediately if you experience symptoms of Osteoarthritis (OA) such as joint pain, stiffness, or difficulty moving. Proper treatment from the start is very important to prevent more serious complications later on.
Article written by dr. Othdeh Samuel Halomoan, Sp.OT (Orthopedic & Traumatology Specialist Doctor, EMC Cibitung & Pekayon Hospital).