Erosive Osteoarthritis: Everything You Need To Know

by Sanjana Lall
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With laptops and phones becoming our constant companions, the concept of perpetual back pain and joint pain has become extremely normalized. So much so that it has almost become synonymous with the word ‘Arthritis’. Although mild joint pains can be cured using home remedies, one should not ignore even the mildest joint pains if they last for more than a week. You never know – it can be a wake-up call for something more severe, life-threatening even. So, here in this article, we are going to talk about one such condition that is somewhat similar to that of arthritis, called Erosive Osteoarthritis. The name at a glance might sound very scary but you need not worry because you are at the right place as this article will help you recognize your symptoms at a much early stage and will inform you about the causes and cures of the same.

Let’s unravel a bit more about Erosive Osteoarthritis :

In case you didn’t know – Osteoarthritis is the most common type of arthritis, affecting over 27 million Americans! It grows progressively over the years, as the cartilage between the joints starts to wear away. An inflammatory form of this very illness, Erosive OA is most commonly portrayed by extreme joint aggravation and bone breakdown. EOA is a progressive disease that more commonly occurs later in life. It is a type of hand osteoarthritis (OA), mostly affecting the interphalangeal joints of the hands and fingers.

It affects approximately 3% of the general population, with women being affected more than men. This condition is more debilitating and causes more grave joint pain and stiffness. It can thrive inside the hinge joints of the fingers and much less often inside the toes. Radiological elements of EOA incorporate joint space narrowing, subchondral sclerosis, minimal osteophytes, and disintegrations. That’s why the radiology erosive osteoarthritis pattern is popularly known as “gull-wing” and “saw-tooth” deformations.  

erosive osteoarthritis
erosive osteoarthritis

Now, let us learn more about this condition as it will help you identify it in its prodromal stage.

What are the most common symptoms of this disease?

EOA is an illness that continues to be under study by medical experts around the globe. So you can be sure of one thing – all its symptoms haven’t made it to the limelight yet. But here’s another catch – generally, the warning signs of this disease develop on the hand joints of the patient and some of the most commonly reported symptoms of erosive osteoarthritis differential radiology are :

  • Swelling
  • Pain
  • Warmth
  • Redness
  • Limited functioning of the hand joints

Besides these, standard radiographs of the hands exhibit a coalescence of bony proliferation and erosions, which give characteristic patterns of the damaged joints, known as “gull-wing” and “saw-tooth” deformities.

What causes this hell of a life-threatening disease? :

Causes of typical standard osteoarthritis can be varied – it can be linked to an unhealed injury that happened a long time ago or can be traced to gradual wear and tear of joints over time. Studies have revealed that women are more affected by Erosive OA than men, causing researchers to believe that hormones might also have a role to play in the emergence of this disease. 

How is Erosive Osteoarthritis diagnosed?

How is Erosive Osteoarthritis diagnosed?
How is Erosive Osteoarthritis diagnosed?

Diagnosing Erosive OA can be a bit difficult as there exists no such globally accepted set of criteria. 

Although Erosive OA is normally characterized by acute joint inflammation and bone breakdown, compared to a typical OA it be difficult to diagnose it with the help of X-ray findings. Laboratory findings, such as ESR, CRP, ANA, RF are usually negative, but a slight increase of ESR and CRP may occur. Recognition of the radiologic manifestations of these diseases may lessen the likelihood of such misdiagnoses.

For diagnostic purposes, the doctor will ask for the patient’s medical history, their family’s history with arthritis especially rheumatoid arthritis which is very similar to Erosive OA, X-Rays of their hands, and perhaps MRI or ultrasound to get a closer look at the erosion. X-Rays are of extreme importance when it comes to detecting Erosive OA, as they can be used to check for systemic inflammation. Normally there shouldn’t be systemic inflammation the way there is with other kinds of arthritis, such as rheumatoid arthritis or psoriatic arthritis. Another reason why X-rays are so important is that they will reveal certain changes of the bone that are characteristic of Erosive OA like- Central bone erosions, Joint space narrowing, Partial dislocation, bony growth, Subchondral cysts (cysts in the bone just below the cartilage), Subchondral sclerosis (hardening of the bone just below the cartilage).

Additional characteristic features include:

  • Diffuse cartilage loss, with joint space narrowing
  • Subchondral erosions (at least two central erosions affecting separate interphalangeal joints); typical central location of the erosions produces the classic “gull-wing” appearance
  • Joint ankylosis
  • Absence of marginal erosions fusiform soft-tissue swelling osteopenia

Understand the correlation between Osteoarthritis and Erosive Osteoarthritis :

Chances of developing this condition be increased if the patient is already suffering from typical osteoarthritis. Research has shown that approximately 2.8 percent is the estimated prevalence of Erosive OA among the general population, and the rate increases to around 10 percent if they have symptomatic hand osteoarthritis.

As stated before, women are more prone to arthritis, especially the ones involving their hands and knees, so it is widely believed that hormones or more precisely the lack of estrogen might have an important role to play here. According to the CDC reports, around 50 percent of the people aged 65 or above have been diagnosed with some kind of arthritis.

How can we treat Erosive Osteoarthritis?

Researchers are yet to find a proper cure for Erosive OA as it is an irreversible progressive condition. Yet, they have managed to come up with the following treatment methodologies for this illness, so far. Let’s check those out :

  1. NSAIDs and analgesics – According to a small survey conducted in 2004, taking the supplement chondroitin sulfate. Along with a Non-steroidal anti-inflammatory drug (NSAID) will slow down the development of erosions. However, it did not cause a significant improvement in the patient’s condition.
  1. Steroid Injection – These will help ease the inflammation and thus will contain the spread of the symptoms, the researches on the benefits of using this has shown a mixed result. Steroid injections strictly be use only a few times in one specific joint.
  1. Heat Therapy – In Erosive OA hot compresses, paraffin wax baths, or other types of heat therapy will help ease the pain.
  1. Occupational Therapy – Day-to-day functions like cooking or even wearing your clothes. It become difficult with limited or restricted mobility of hands and fingers. An occupational therapist will help the patient with that and teach them range-of-motion exercises and bring about lifestyle changes to make their lives a bit less painful.

Conclusion :

Symptoms of Erosive OA are very easily confused with that of traditional osteoarthritis, although in Erosive OA pain areas. So, Swelling are mostly concentrated on the hands and fingers. Various studies have reported on clusters of cases of Erosive OA within families. It hints at the possibility of the condition having a strong genetic component. So in a nutshell, if you have arthritic symptoms, it is advisable to go see a doctor, a rheumatologist preferably. But for now, try to correct your posture and also try and limit your average screen time. Thank me later.

Frequently Asked Questions (FAQs) :

Q. What is the difference between Osteoarthritis and Erosive Osteoarthritis?

Ans. Erosive OA is usually more severe in nature and causes more pain, swelling, and functional disability in the targeted joint than typical osteoarthritis.

Q. How fast does Erosive Osteoarthritis progress?

Ans. It depends on the severity of the condition. In some extreme cases, Osteoarthritis will remain stable for decades at a stretch, while in other cases it may start progressing very rapidly leading to complete erosion of the cartilage in the span of a few months.

Q. What is Non-erosive osteoarthritis?

Ans. They are very similar to Erosive OA with similar degenerative and distribution changes, but they are devoid of any type of erosions.

Q. Can Erosive OA be reversed?

Ans. No. Erosive OA is a progressive irreversible condition that develops gradually over time.

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