Recently, a patient I was taking care of in the ER pulled up her X-ray report on her phone and became alarmed. ‘Doc, it says here that I have degenerative joint disease! That’s serious, right?” I explained to her that degenerative joint disease is the medical term for arthritis. To make things clear, I grabbed my book, Diagnosketch, and turned to Page 76. I pointed to the illustration and explained:
On the left, there are two joints (the top is a hip, and the bottom is the spine). Take a look and see that the bones are smooth and regular. Normal joints are covered with spongy cartilage that helps protect them. Arthritic joints have worn-down cartilage and exposed bone. This results in bone hitting up against bone, causing inflammation and pain. It can also cause the growth of bony spurs (called osteophytes). Look at the images on the right. Here, the bones are ratty and irregular. This is what happens with arthritis. There are many types of arthritis (ie. osteoarthritis, rheumatoid arthritis, psoriatic arthritis). The most common type is osteoarthritis, also known as wear-and-tear arthritis. It happens naturally as we age, over many years. It occurs most commonly in the lower spine, hip, neck, hands, and knee. So, to clarify:
Degenerative Joint Disease = Osteoarthritis = Wear-and-Tear Arthritis
Sometimes, we call it degenerative joint disease because it’s more descriptive of what is happening. Sometimes, if we say ‘arthritis,’ patient confuse it with other inflammatory arthritis (like rheumatoid arthritis). Saying degerative joint disease helps a patient understand that it is because of degeration of the joints and cartilage.
We see a lot of osteoarthritis of the knee in the ER. Take a look at Page 86, Diagnosketch. The left depicts a normal knee. Notice the layer of cartilage that covers the ends of the bones. The fluid helps buffer the impact. The right image depicts an arthritic knee. Notice the cartilage has broken down, causing the bone to hit up against the bone. Often, because of the pain and inflammation, the knee swells up and causes a joint effusion (yellow in the picture).
Once I explained these words with pictures, my patient told me it wasn’t so scary after all. And, on a side note, we often say ‘DJD’ as a shortcut to degenerative joint disease.
There’s no cure for DJD, but its symptoms can be managed by maintaining a healthy weight, staying active, and using certain medicines that can slow the progression of the disease and help improve pain and joint function.*info from Mayo Clinic, Cleveland Clinic, and NIH websites.
- 14% of all Americans have DJD; it’s more common in people over 65 and more common in women than men
- Depending on the severity and the joint involved, some 50-80% of DJD can be seen on a simple X-ray.
- There’s no cure for DJD, but its symptoms can be managed by maintaining a healthy weight, staying active, and using certain medicines that can slow the progression of the disease and help improve pain and joint function.
- *info from Mayo Clinic, Cleveland Clinic, and NIH websites.