Introduction. Knee osteoarthritis is a progressive degenerative disease of the entire joint that leads to functional limitations and reduced quality of life. The end-stage of the disease is associated with disability and a significant burden both for the patient and the society. Osteoarthritis and metabolic syndrome. Metabolic syndrome is a group of cardiovascular risk factors including diabetes and hyperglycemia, abdominal obesity, hypercholesterolemia, and hypertension. The adverse effects of the metabolic syndrome are associated with worsening of the clinical manifestations and disease prognosis through the combined effects of metabolic disorders. It has also been suggested that individual components of the metabolic syndrome may be an independent risk factor for knee osteoarthritis. Osteoarthritis and diabetes mellitus. Experimental and epidemiological evidence supports the role of type II diabetes mellitus in the pathogenesis of osteoarthritis. Chronic hyperglycemia leads to oxidative stress and excessive production of proinflammatory cytokines, while insulin resistance can act locally and systemically through chronic low-grade inflammation. Osteoarthritis and hypertension. The mechanism that explains the relationship between osteoarthritis and hypertension is unclear. Several potential pathways for subchondral bone damage due to hypertension have been described. Osteoarthritis and dyslipidemia. Experimental studies suggest that dyslipidemia may be involved in the pathophysiological process of osteoarthritis, while epidemiological studies show heterogeneous results. Conclusion. Patients with knee osteoarthritis require a holistic approach in which the emphasis is not only on symptomatic pain relief, but also on the treatment of metabolic disorders.
Introduction. Hand osteoarthritis is a joint degenerative disease characterized by hand deformities affecting the hand strength and function, leading to greater disability and increased healthcare utilization. The objective of this study was to estimate the impact of different risk factors on the incidence of hand osteoarthritis. Material and Methods. The study was a prospective cross-sectional study conducted at the Special Hospital for Rheumatic Diseases Novi Sad, Serbia, during a one year period (2017 - 2018). It included 100 postmenopausal women aged 60 to 70 years presenting with pain in the hands ? 3 according to the visual analogue scale. All respondents were divided into two groups, according to radiographic findings graded using the Kellgren-Lawrence scale. Risk factors responsible for the development of hand osteoarthritis were examined and the research procedure included medical history data, physical examination of the hand joints, anthropometric measurements, and laboratory tests. Statistical processing and analysis was performed using Statistical Package for the Social Sciences ver. 25. Results. Statistically significant differences were found between the two groups in relation to positive family history of degenerative changes in the hand joints (p = 0.000), as well as in relation to metabolic syndrome (p = 0.001). Conclusion. A positive family history of degenerative changes of the hands and presence of metabolic syndrome are significant risk factors for the development of hand osteoarthritis.
Background: Osteoporosis is a chronic disease that results in microarchitectural changes to the bone, thereby reducing its density and increasing the risk of fractures. This retrospective cross-sectional study aimed to examine the link between the risk of major osteoporotic fractures and hip fractures with the age of menopause onset, as well as the impact of menopause duration on fracture incidence. Methods: This retrospective cross-sectional study was conducted at the Special Hospital for Rheumatic Diseases, Novi Sad, Serbia. The data required for meeting the study objectives were obtained from patients’ medical records spanning the 2015-2018 period. The sample for the study comprised of 985 postmenopausal women aged ≥ 50 yr who underwent bone mineral densitometry examination and received a FRAX score for major osteoporotic fractures and hip fractures with and without bone mineral density. The obtained FRAX scores were compared across the subjects with respect to the age of menopause onset and menopause duration. Results: The group that entered into menopause before the age of 45 had a high risk of hip fracture (OR: 1,652; 95% CI: 1,138 - 2,399; P<.01) and a higher mean FRAX score for hip fracture compared to women in whom menopause started after the age of 45 (Me=1.60 vs. 1.30, P<.004). FRAX scores were also correlated with menopause duration, and the difference between the groups with the longest (over 20 yr) and the shortest (1–10 yr) duration was statistically significant at P<.001. Conclusion: As menopause duration could contribute to the prediction of fracture risk, its inclusion in the FRAX algorithm should be considered, while also taking into account the age of menopause onset.
Introduction. The purpose of treating osteoarthritis is to relieve pain, improve the function of the osteoarthritic joint, and arrest further development of osteoarthritis through non-pharmacological and pharmacological treatment modalities. Pharmacological osteoarthritis therapy. In the treatment of osteoarthritis, guidelines and recommendations are often consulted, but they do not dictate the treatment mode, which is tailored to the individual needs of the patient. These guidelines promote desired and positive treatment outcomes, but cannot predict a specific outcome. They are also valuable when analyzing the use of topical and oral non-steroidal anti-inflammatory drugs, keeping dosage as low as possible for the shortest time. For example, monitoring hepatotoxicity is advised when administering paracetamol, while caution is needed when prescribing drugs with a central effect due to the possible development of addiction and appearance of toxic effects. A significant body of research on the use of chondroprotectors exists, but there is a large discrepancy across studies. Nonetheless, their findings indicate benefits of intra-articular administration of glucocorticoids. However, their more frequent administration can lead to accelerated cartilage loss, while guidelines differ concerning intra-articular administration of hyaluronic acid, the administration of plasma enriched with platelets, and the administration of stem cells due to the heterogeneity of the preparations and the lack of standardization in their administration. Conclusion. Non-surgical therapy is a growing field of research, especially from a pharmacological point of view, intending to find the best treatment to slow down or completely stop further development of osteoarthritis.
Introduction. Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density and damage to the bone microarchitecture, which leads to bone fragility, thus increasing the risk of osteoporotic fractures. While different diagnostic methods can be employed for detecting bone mineral density decrement in a timely manner, dual energy X-ray absorptiometry remains the gold standard in research and clinical practice. Bone mineral density estimation methods. Osteoporosis can be diagnosed through conventional radiography, quantitative ultrasonography, quantitative computed tomography, and magnetic resonance. Nonetheless, dual energy X-ray absorptiometry is the gold standard in the diagnosis of osteoporosis on which further treatment and monitoring are based. The dual energy X-ray absorptiometry apparatus is equipped with the Fracture Risk Assessment Tool, which estimates the 10- year probability of a major fracture and hip fracture due to osteoporosis. The use and interpretation of osteoporosis diagnostic evaluation modalities is based on the International Society for Clinical Densitometry guidelines for diagnosing osteoporosis in adults and children. According to the International Society for Clinical Densitometry recommendations, the aforementioned quantitative visualization modalities should be used alongside laboratory analyses of bone metabolism markers to supplement diagnostics and monitor treatment efficacy in patients suffering from osteoporosis. Conclusion. Assessment of risk factors and early diagnosis are prerequisites for timely treatment and effective monitoring, which is necessary for arresting the progression of bone mineral density loss and preventing the occurrence of osteoporotic fractures.
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