Reviewed By: Pramod Kerkar, MD, FFARCSI

What is Erosive Osteoarthritis?

Erosive Osteoarthritis refers to a progressive medical disorder which affects the interphalangeal joints of hands. It is an uncommon subset of osteoarthritis. The symptom of Erosive Osteoarthritis involves both inflammatory and degenerative effects in the DIP and PIP joints of hands. In case of Erosive Osteoarthritis, the location is considered some characteristics of the disease. Erosive Osteoarthritis is at times also referred to as an inflammatory variant of osteoarthritis. In this case, pain, erythema, warmness, and reduced function of joints are mainly seen in most patients. The radiograph of the hands shows the combination of bony spread and erosions. The affected joints are known as “gull-wing” and “saw-tooth” deformities. Due to the excessive osseous spread, there are severe deformities including interphalangeal ankylosis.

What is Erosive Osteoarthritis?

Symptoms of Erosive Osteoarthritis

Erosive Osteoarthritis begins with acute onset of extreme tenderness in multiple finger joints along with varying degrees of erythema, stiffness, swelling, and warmth. X-rays of hands of an individual with this condition will show central erosions. These erosions are normally cracks on the surface of the in the center of the joints. There are some reasons or symptoms of this particular disorder. These are:

  • Osteophytes which is recognized as bony growths.
  • Cysts in the bone underneath the cartilage also known as Subchondral Cysts.
  • Partial dislocation of the bone also referred to as subluxation.
  • Ankylosis.

The inflammatory joint disease is related to this disorder. The affected person may suffer from the back and neck pain. They may also face the subarticular bone erosions, osteophyte formation, and subchondral cysts.

Prevalence of Erosive Osteoarthritis

Females are affected more than males by this condition. Nowadays, more people are found to be affected by this disorder. Actually, 40% of people face this “erosive changes”. There are many people who have hand osteoarthritis may ultimately end up having Erosive Osteoarthritis.

Diagnosis of Erosive Osteoarthritis

Medical History for Erosive Osteoarthritis:

The proper diagnosis of erosive osteoarthritis is still quite challenging. The doctors first get a detailed history of the patient, conduct a thorough physical examination and based on the symptoms and results of radiographs come up with a diagnosis of Erosive Osteoarthritis. The doctors may also ask you some questions about any family history of rheumatoid arthritis as it is probably associated with erosive osteoarthritis. The affected individual may also suffer from slight fever, persistent fatigue, and unintentional weight loss.

Physical Examination to Diagnose Erosive Osteoarthritis:

The doctor will first perform a medical history and physical examination in order to diagnose Erosive Osteoarthritis. The doctors will examine the hands of the affected individual by pressing on the finger joints in order to assess for any palpable tenderness, visible swelling, erythema, or warmth. The doctor will also assess strength and motion of the fingers. In the case of erosive osteoarthritis, joint pain, stiffness, and decreased joint function are significantly severe than the common form of hand osteoarthritis. The doctors may also examine the other joints of the affected person apart from hands, like wrists and elbows. Elbows and wrists are generally affected in rheumatoid arthritis but that is not the case in erosive osteoarthritis. In this disorder, the knuckles of the hand and the hand joints are generally not affected due to erosive osteoarthritis.

Blood Tests to Diagnose Erosive Osteoarthritis:

The affected patients will have to do some blood tests that are prescribed by the doctors. These blood tests are:

  • ESR Blood test
  • CRP
  • Blood test for rheumatoid factor.
  • These blood tests should be normal in cases of erosive osteoarthritis.

X-rays for Erosive Osteoarthritis:

X-rays are very important in order to diagnose erosive osteoarthritis. The proper images showing central erosions of the hands play a big role in confirming the diagnosis.

Treatment of Erosive Osteoarthritis

The treatment of erosive osteoarthritis is restricted in order to control the overall symptoms. In this case, the non-pharmacologic therapy in the form of moist heat, paraffin baths, splinting and various motion exercise is needed. So, the overall treatment for Erosive Osteoarthritis is challenging. According to the new and advanced research, many new therapies are coming up to treat Erosive Osteoarthritis. The adalimumab treatment can be an effective one for erosive osteoarthritis. Deformity of the hands with impaired functionality occurs due to erosive osteoarthritis and hence, patients need early treatments. The inflammation due to erosive osteoarthritis generally resolves with adequate medical management.

The invention of biological therapies for the treatment of inflammatory arthritis has revolutionized the field of rheumatology. All the affected patients tolerate the medication very well. There are some affected individuals who require hospitalizations during the treatment. Erosive osteoarthritis should be distinguished into three main subtypes such as Erosive hand Osteoarthritis of IP joints, Erosive hand Osteoarthritis of TB joints and Erosive Osteoarthritis of the facet joints.

If there is someone who is affected by Erosive Osteoarthritis, then he/she will have to go to a physician specializing in joint conditions. With some good medications and therapies, the affected person can optimize his/ her joint health. The clinical syndrome of this particular disorder usually includes localized neck and back pain with some degree of radiation into the upper and lower limbs.

Women are easily affected by this disorder than men. The prognosis of Erosive Osteoarthritis is generally good with the condition being in remission several years after the initial diagnosis. In many cases, the morning stiffness lasts as long as one hour in people with Erosive Osteoarthritis. Antirheumatic medications and other biological treatments like infliximab are still under investigation but the overall results from these tests are quite promising. However, different treatment might be needed for handling the different symptoms of Erosive Osteoarthritis.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: October 31, 2018

This article does not provide medical advice. See disclaimer

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