Study on Epidemiology, Etiology, Pathology, Pathogenesis, Mode of Presentation and Clinical Features of Osteoarthritis of Various Joints from Cases Who are Attending Tertiary Care Hospital

Aim: To study the clinical profile, epidemiology, causes and clinical features of osteoarthritis. To identify the commonest joint involvement in osteoarthritis. To evaluate the incidence of primary OA from secondary osteoarthritis. To extrapolate the clinical features with pathology and pathogenesis of osteoarthritis. To how to avoid pitfalls in the diagnosis of primary osteoarthritis from secondary arthritites. Objective of the Study: Across the globe, osteoarthritis is a commonest disability prone disease. As against in the past, quite large number of cases are presenting with this disease are not just in old but from above middle ages. All over the countries, in both sexes, the life expectancy is being appreciably increased and likewise, because of the rise in affluency and easy reach of opulent diets, most of them became obese with plumb and bellies and unfortunately, its often being seen in young and above middle ages. Thus, ultimately leads to secondary flat foot and increase in intra-articular hypertension, medial and lateral tibiofemoral compartmental stress and repetitive injuries. If any one or all these modifiable, non-modifiable and perpetual causes are not removed, then one has to welcome the early onset of osteoarthritis. As there are numerous cases are coming with features of OA to rheumatology out-patient department, We have aimed to do systematic and prospective study on osteoarthritis from August 2006 to July 2018 and it was conducted in two different centres, namely in rheumatology out-patient department of the Government Mohan Kumaramangalam Medical College and Hospital, Salem and another one in Akitha Hospital, Centre of Excellence for Autoimmune Diseases, Seelanaickenpatti, Salem, Tamil Nadu State, India. Material and Methods: More than a decade of my experience on osteoarthritis of various joints from cases who has attended to rheumatology out-patient department of Government Mohan Kumaramangalam Medical College and Hospital and from Akitha Hospital, Centre of Excellence for Auto Immune diseases, Salem, Tamil Nadu State of India are have been included for this systematic and prospective on going study on osteoarthritis for the epidemiology, causes, pathology, pathogenesis and clinical features. Quite often, rheumatologist see OA cases at bit late and mostly they are coming either with wrong diagnosis or with or after erroneous treatments with high dose steroid and various DMARDs as rheumatoid arthritis. Thus, in this article, attempts have been taken for the ways to reduce or avoid pitfalls either in the investigations or in the diagnosis of primary OA from secondary osteoarthritis before initiating proper treatment. There are 3208 cases (M-1759 & F-1449) have been enrolled for this study and based on the age of presentation, they were categorized into 3 groups. Ages from 35-50 years are in Group-A, (in 538, M-177 & F-361), 51-70 years of ages in Group-B, (in 1846, M-1181 & F-665) and from 71 years and above are in Group- C (in-824, M-401 & F-423). Results: The youngest and oldest ages was seen, 35 and 92 years old, female and male, respectively. In Group-1, female out numbered the male (female 67.10 % (n-361) and male 32.89 % (n-177) and in Group- B, male with OA are higher than female (male 63.97 % and female 36.02 %, whereas, more or less equal in both sexes in Group-C, as 48.66 % and 51.33 %, in male and female, respectively. Among both sexes, knee is most commonly involved joint. Unilateral OA knee is the usual clinical presentation in age group less than 50 years but after fifty, bilateral knee involvement was noted. Next to knee, OA hand was found and least was found in elbow joint. Another interesting features was observed that obesity has strongest association with OA and it was the predominent cause for the OA in young female. In our study, obesity was found as a significant cause in age group less than 50 years and it was predominently seen in female (57.06 %) than male (30.50 %), whereas in other two groups, it was found equally in both sexes. Conclusion: Osteoarthritis is a common articular disease and it often limits the activites and earning capacity of above middle aged individuals and it is a crippling disease in ages after 70 years. Strongest associations was noted in larger proportions of obese young individuals as a predominent cause for OA as because of every country in world are increasingly experienced with plemb and bellys population. Osteoarthritis of knee was found as a common presentation to our two centres, next is hand and least was found in elbow joint.