Difference Between Osteoarthritis And Osteoporosis

OSTEOARTHRITIS(OA)

WHAT IT MEANS

WHAT IT DOES

CAUSES

• Being overweight, joint strength, and joint injury/trauma

Non-Modifiable factors:

• Genetics, ethnicity, gender (female; after age 45), aging.

Research has shown that muscle weakness can contribute to osteoarthritis and muscle wasting is a common occurrence.

• Overactive thyroid gland (hyperthyroidism)
• Reduced estrogen in women due to menopause or removal of uterus(hysterectomy), ovarian issues, pituitary and hypothalamus related issues, low thyroid functioning or cancer therapy and reduced testosterone in men due to testicular injuries, cancer therapy, low thyroid function, issue with the pituitary gland or hypothalamus (part of brain)
• Pituitary gland issues like masses in the pituitary or hypopituitarism (underactive pituitary).
• Overactive parathyroid glands (hyperparathyroidism)
• Family history of osteoporosis
• History of fractures/broken bones after age of 50
• History of being underweight or having low Body mass index (BMI) <=19
• Long-term use of high-dose steroid medications
• Eating disorders like anorexia or bulimia
• Heavy drinking and smoking
• Rheumatoid arthritis
• Coeliac disease and Crohn's disease are both autoimmune diseases that cause gluten intolerance and malabsorption of nutrients like Vitamin D which can lead to osteoporosis. They also cause the release of pro-inflammatory cytokines, calcium malabsorption, and the activation of osteoclasts(cells that breakdown bone tissue) which again lead to bone weakening and loss of density.
• Long-term bed rest or inactive state can also lead to bone loss due to inability to perform any weight bearing activities and decreased activity of osteoblasts (bone building cells)

SYMPTOMS and SIGNS

• Soreness or stiffness in joints such as the hip , knees or back because of inactivity or overuse
• Crackling sound from joints on movement
• Mild swelling or pain around the joint
• Pain and stiffness that increases more towards the end of the day
• Limitation of movement or stiffness that improves as the joint is mobilized

• Insidious in the earlier stages unless one has a fracture when it’s incidentally discovered during investigations
• Painless initially, pain may occur in later stages
• Honeycomb sign : Under a microscope, the inside of a bone resembles a honeycomb. In osteoporosis, the bone, that forms the margins of the honeycomb, gets smaller, and the spaces between the bones grow larger. The outer margin of the bone becomes thinner.

HOW IS IT DETECTED?

• Physical examination
• Ultrasound of the joint
• X-ray of the joints
• Blood tests

• Physical examination
• Ultrasound
• Bone density (BMD) testing called DEXA Scan, or dual-energy-x-ray-absorptiometry. Its shows valued as the T score.
• The T-score in the bone density (BMD) report depicts the variation of your bone mass from that of an average healthy 30-year-old adult. A T-score is a “standard deviation” — a mathematical calculation that’s calculates the variation of your result from the average or mean. The T score that you get from your bone density (BMD or DXA) test is measured as a standard deviation from the mean.

PREVENTION & SCREENING:

• Almost everyone develops some degree of osteoarthritis as we age from the day-to-day wear and tear from activities.

Prevention tips:

1. Maintain a healthy weight
2. Keep a check and control blood sugar
3. Regular exercise:
   Aquatic or water exercise is beneficial only in the beginning and in obese people. Land-based aerobic and strengthening exercises have a long-lasting effect. All the beneficial effects that come with exercise vanish once it is discontinued.
4. Protect joints from injury.

Screening for early identification of osteoarthritis

• During routine checkups always discuss with your doctor for screening of arthritis. Check for:
  • Any history of restriction of movement of joints
  • Bone enlargement
  • Crepitus (the popping, clicking or crackling sound) felt during movements of joints
  • Age >50 years (routine examination of joints)
  • Tenderness and or swelling of joints
• Screening questionnaires like the Early Osteoarthritis Questionnaire (EOAQ) which is used as a tool to assess knee osteoarthritis at initial stage.
• Xray/MRI of joints in case of any suspicious symptoms or indications of early OA during routine preventive health checks

Can be primarily prevented by:

1. Eat foods that keep the bones healthy: Get enough calcium, Vitamin D and protein from food.
   • low-fat dairy
   • green leafy vegetables
   • fish
   • fortified food and beverages
   • milk
   • grains
2. Increase physical activity: Try weight-bearing exercises, including strength training, walking, dancing etc.
3. Quit Smoking if you smoke
4. Avoid/Limit alcohol intake
5. If your vitamin D level is low, talk to your doctor about supplementation.
6. Avoid activities that may cause a fracture
   • Exercise to improve balance and strength
   • Wear the right shoes to provide support and prevent slipping that may increase chances of a fracture
   • Be mindful of the possible side effects of the medications you maybe taking for high BP etc. that may cause dizziness and falls leading to fractures

• Screening for early identification of osteoporosis
• Maintain a record of history of falls in adulthood.
• Perform BMD (DEXA SCAN/Bone Mineral Density)
  • In women ≥ 65 years and men ≥ 70 years.
  • In postmenopausal women and men 50–69 years
  • In postmenopausal women and men ≥ 50 years with a history of fracture in adulthood
  • It’s advisable to go to the same facility and get the scan on the same densitometry device for each screening to avoid/minimize errors.