Classification of osteoarthritis
Osteoarthritis can be classified into two categories: idiopathic (primary) and secondary, based on the presence or absence of local and/or systemic pathogenic factors. Primary OA is defined as OA in which the cause of the disease cannot be identified by current methods.Tables 1, 1A and 1, 1B are the classification of osteoarthritis developed by the International Osteoarthritis Conference in 1986.
Primary osteoarthritis is divided into two categories: localized and systemic. Systemic osteoarthritis requires invasion of 3 or more joints.
However, in actual clinical practice, it is difficult to make a definitive diagnosis for a particular patient or population using the above definitions. We still use traditional diagnostic criteria, such as the presence or absence of radiographic evidence of osteoarthritis.
Localized
Heberden and Bouchard nodes of the hand
Eroding interphalangeal arthritis (no nodes)
First carpometacarpal joint
Exostosis of the foot
Ankylosis
Hammertoe (toe contracture)
Talonavicular arthritis
Hip eccentricity (superior)
Concentric (axial and medial)
Diffuse (age-related hip osteoarthritis)
Small spinal synovial joints
Intervertebral joints (intervertebral discs)
Ankylosing spondylitis
Ligamentous sites (bone hypertrophy, Forestier’s disease, idiopathic diffuse bone hypertrophy)
Other single sites
Glenohumeral joint
Acromioclavicular joint
Tibial talocrural joint
Sacroiliac joint
Temporomandibular joint
Systemic
Including 3 or more of the above joints
Table 1, 1B Classification of secondary osteoarthritis
Trauma
Acute
Chronic (occupational, athletic)
Congenital or developmental
Localized disease
Legg-Calve-Perther disease (osteochondrosis)
Congenital dislocation of the hip joint
Slipped epiphysis
Acetabular dysplasia
Mechanical factors
Inequality of lower limbs
Internal and external knee deformity
Hypermobility syndrome
Scoliosis
Metabolic diseases
Brownish yellow disease
Hemochromatosis (hemochromatosis)
Wilson disease (exfoliative dermatitis)
Gaucher’s disease (familial splenic anemia)
Uric aciduria
Endocrine
Acromegaly osteoarthritis
Hyperparathyroidism
Diabetes mellitus
Obesity
Hypoparathyroidism
Calcium deposition disease
Calcium 2-Pyrophosphate Deposits
Apatite arthropathy
Other bone and joint disorders
Localized Diseases
Fractures
Aseptic osteonecrosis
Infections (septic or tuberculous arthritis)
Gout
Diffuse
Rheumatoid (inflammatory) arthritis
Paget’s disease of bone
Osteosclerosis
Osteochondritis
Neuropathic arthropathy (Charcot joint)
Hemophilic arthropathy
Endemic diseases
Macroosteoarthropathy (endemic deforming osteoarthropathy)
Mseleni’s disease
Other secondary joint diseases of different nature
Frostbite
Diver’s disease
Hemoglobinopathies
Table 1, 2 Diagnostic criteria for osteoarthritis of the knee
Clinical manifestations.
1, Most of the knee joint pain in the past few months
2, babbling sound when the joint is moved
3, joint stiffness ≤ 30 minutes in the morning during onset
4, age ≥ 38 years
5, bony enlargement of the knee joint seen on examination
With 1, 2, 3 and 4, or 1, 2 and 5, or 1 and 5 above, osteoarthritis of the knee can be diagnosed. It has a sensitivity of 89% and a specificity of 88%.
Clinical manifestations, laboratory tests and radiological criteria.
1, Most of the knee joint has been painful in the past few months
2. Bone growths at the joint edges
3, synovial fluid analysis for typical OA performance
4, age ≥ 40 years
5, joint stiffness ≤ 30 minutes in the morning during the onset
6, joint movement with babbling sound
With 1 and 2, or 1, 3, 5 and 6, or 1, 4, 5 and 6 above, osteoarthritis of the knee can be diagnosed. Its sensitivity is 94% and specificity is 88%.
Table 1, 3 Diagnostic criteria for osteoarthritis of the hand joint
Clinical manifestations.
1, pain or stiffness in the hand most of the time in the past few months
2, 2 or more of the 10 designated joints have bony enlargement
3, swelling of no more than 3 metacarpophalangeal joints
4.Severe swelling of 2 or more distal interphalangeal joints
5.Deformity in 2 or more of the 10 specified joints
With 1, 2, 3 and 4, or 1, 2, 3 and 5 above, osteoarthritis of the hand joint can be diagnosed. Its sensitivity is 92% and specificity is 98%.
The 10 designated joints included the 2nd, 3rd distal and proximal interphalangeal joints, and the 1st carpometacarpal joint.
Table 1, 4 Diagnostic criteria for osteoarthritis of the hip joint
Clinical manifestations, laboratory tests and radiological criteria.
1, Most pain in the hip joint in the past few months
2, the presence of femoral side and/or acetabular side bony bulge on x-ray
3.Blood sedimentation ≤20mm/h
4, age ≥ 40 years