Osteoarthritis in southeast Asia

Abstract

Osteoarthritis Osteoarthritis (OA) is a multifactorial and complex disease that involves change in articular bone and cartilage structure. The multifactorial nature of OA is that the disease is not a single entity, but encompasses many entities, including the the loss of cartilage within synovial joints, hypertrophy of bone, and thickening of the capsule. The complexity is in the causality and etiology of the disease as its risk is determined by multiple, and probably interactive, effects of genetic and environmental factors. A reasonable definition that can capture the complex ity and multifactorial nature of the disease is “a heterogeneous group of conditions that lead to joint symptoms and signs, which are associated with defective integrity of of cartilage, in addition to related changes in the underlying bone at the joint margins” [1]. Although OA can affect any joint in the body, it is often found at the hands, knees, hips, and spine. A challenge in studies of OA is in the diagnosis. There is a considerable disparity between clinical and radiologic diagnoses. There are many radiologic methods for diagnosing OA, but the Empire Rheumatism Council system of grading first described by Kellgren and Lawrence [2] is probably the most widely used scale in epidemiologic studies. The Kellgren–Lawrence method is actually a system of OA grading based on the presence or absence of osteophytes, joint space narrowing, subchondral sclerosis, and bony cysts. In an epidemiologic study, it was noted that while the prevalence of clinically diagnosed knee OA was approximately 18%,