Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada.
J Pharm Pharmacol. 2014 Mar;66(3):339-46. doi: 10.1111/jphp.12196. Epub 2013 Dec 13.
Osteoarthritis (OA) of the hand can be a debilitating condition that hinders an individual's quality of life. With multiple joints within the hand that are commonly affected OA, an individual's ability to use their hand in everyday movements become more limited. The article aims to review literature on the aetiology and pathogenesis of OA, risk factors, characteristics of hand OA and the steps of diagnosis.
The aetiology and pathogenesis of OA, in particular hand OA, is not fully understood. However, it is known that several factors play a role. Environmental factors, such as stress from mechanical loading, especially to vulnerable joints predispose individuals to developing OA. Extracellular matrix changes in protein levels have also been noted in individuals with OA. Linked to hand OA development are boney enlargements (Herbeden's and Bouchard's nodes). Several risk factors for OA include: age, obesity, gender, smoking, genetics, diet and occupation. Various diagnostic methods include a combination of using radiographic methods, clinical presentation, a number of developed measurements and scales.
With OA having several risk factors and various causes and contributing elements, it is important to elucidate the pathogenesis of OA and determine exactly how risk factors play a role in its development. Because of the contributions from several elements, diagnosis is best when it uses multiple methods. In turn, understanding OA and making better diagnoses could lead to improved management of the condition through both pharmacological and non-pharmacological interventions.
手部骨关节炎(OA)可能是一种使人衰弱的疾病,会影响个人的生活质量。手部有多个关节容易受到 OA 的影响,因此患者日常手部活动的能力会受到更大限制。本文旨在综述 OA 的病因学和发病机制、危险因素、手部 OA 的特征以及诊断步骤的相关文献。
OA,特别是手部 OA 的病因学和发病机制尚未完全阐明。然而,已知有几个因素在起作用。环境因素,如机械负荷引起的压力,尤其是对脆弱关节的压力,使个体易患 OA。OA 患者的细胞外基质蛋白水平也发生了变化。与手部 OA 发展相关的有骨隆起(赫伯登结节和博卡结节)。OA 的几个危险因素包括:年龄、肥胖、性别、吸烟、遗传、饮食和职业。各种诊断方法包括结合使用放射学方法、临床表现、一些已开发的测量和量表。
OA 有几个危险因素和多种病因及相关因素,阐明 OA 的发病机制并确定危险因素在其发展中的作用非常重要。由于涉及多个因素,最好使用多种方法进行诊断。反过来,了解 OA 并做出更好的诊断可以通过药物和非药物干预来改善对这种疾病的管理。