Common orthopedic diseases Introduction Osteoarthritis (a) osteoarthritis (OA), also known as degenerative joint disease, osteophytic arthropathy, hypertrophic osteoarthropathy, age-related arthropathy, the most common chronic, progressive joint disease. Shanghai Deji Hospital Orthopedic Department He Bo lesion site cartilage changes: articular cartilage degeneration is the most basic pathological changes in OA, manifested by the loss of cartilage elasticity, cracking, erosion, ulceration, fragmentation, shedding. The subchondral bone is exposed, causing pain during weight-bearing activities; the marginal cartilage proliferates and hardens to form cartilage redundancy. The detached bone may form an intra-articular free body. Bone changes: subchondral bone microfracture, osteonecrosis, fat and inflammatory tissue filling, reactive hyperplasia and sclerosis. Marginal bone redundancy formation (bone spurs); may cause periarticular pain. Synovial changes: generally secondary, early may be congestion, restricted peritubular lymphocytes, inflammatory cell infiltration, increased inflammatory exudate, joint effusion; synovial villous hyperplasia, loss of elasticity. Synovial chondrosarcoma formation may present with joint interlocking. Changes in joint capsule, ligaments, and muscles: thickening of joint capsule, contracture of edges and ligaments, and sclerosis of attachment points. Muscle wasting atrophy and decreased muscle strength. Soft tissue contracture, resulting in deformity, limited joint movement and even pain. Etiology 1, general factors: genetic factors, gender, advanced age, obesity, sex hormones, bone density, excessive exercise, smoking and the presence of other diseases. 2, mechanical factors: trauma, abnormal joint morphology, long-term repeated use of a joint occupation such as ballet dancers ankle; strenuous sports activities such as weightlifting athletes knee, living environment (the incidence of the north is higher than the south), congenital developmental abnormalities (adult hip dysplasia). Commonly involved joints 1. Hand: Most commonly seen in middle-aged and elderly women, with the distal interphalangeal joint most commonly involved, also seen in the proximal interphalangeal joint and the first carpometacarpal joint. Pain and tenderness are less pronounced. It is characterized by bony enlarged nodules on the dorsal and lateral surfaces of the interphalangeal joints, Heberden’s nodule in the distal interphalangeal joint and Bouchard’s nodule in the proximal interphalangeal joint. There is a genetic predisposition, often in both mothers and daughters. 2. Knee: Pain and stiffness, alternating unilaterally or bilaterally, mostly when walking up or down stairs. Swelling of the joints, pressure pain, bone rubbing sounds, internal and external knee deformities. 3. Foot: The first metatarsophalangeal joint of the foot is the most common. It is aggravated by wearing tight shoes. Capsulitis causes swelling and pain, osseous hypertrophy and ectropion of the m toe. The remaining toe and tarsal joints may also be hyperplastic and deformed. 4, spine: including synovial and intervertebral disc degeneration, synovial and intervertebral disc degeneration are two different pathological processes. The synovial joints and other joints osteoarthritis pathological changes are the same, intervertebral disc degeneration is mostly accompanied by vertebral lip-like bone redundancy, the two are closely related. The cervical and lumbar spine are more common. It is characterized by pain, stiffness, and restricted movement in the cervical or lumbar spine, and is triggered or aggravated by prolonged sitting or standing. The pain may radiate to the buttocks or lower extremities. The pain is aggravated by extension, and aggravated by flexion, suggesting intervertebral disc disease. 5, hip: hip OA is mostly seen in older people, with a higher prevalence in men. The main symptom is the insidious occurrence of pain, can be radiated to the lateral hip, groin, inner thigh, sometimes can be concentrated in the knee and ignore the real lesion site. Physical examination reveals varying degrees of activity limitation and claudication.