Pathophysiology

Generally seen in those aged over 65 years, can be brought on by previous surgery, previous trauma (e.g. fracture), inflammatory condition (e.g. rheumatoid arthritis) or overuse injuries.

There is often a poor link between changes visible on an x-ray and symptoms of osteoarthritis; minimal changes can be associated with a lot of pain, or modest structural changes to joints can occur with minimal accompanying symptoms.

Osteoarthritis is a condition that results from a loss of cartilage with subsequent remodelling of adjacent bone and subsequent inflammation. It is some of these changes in the joint structure that can then be seen on x-ray. It is a dynamic process that involves all joint tissues: the bones, cartilage, joint capsule, lubricating fluid and surrounding muscles.

Sometimes the altered joint structure compensates for the changes and does not cause pain. It’s when the natural repair process cannot compensate enough that the joint starts to become painful.

Symptoms

• Stiffness on elbow movements and restriction in range of movement
• Grinding, grating or clicking noises from the elbow
• Pain at end of range positions- bending and straightening the elbow
• Generally non -specific distribution of pain

Management

• Activity modification
• Ice or heat
• Pain relief
• Physiotherapy

Investigations

X-ray can assess the level of Osteoarthritis but is unlikely to change the management