Arthritis

Osteoarthritis: Arthritis is very prevalent and the most common cause of disability (Figure 29.1). Both osteoarthritis and rheumatoid arthritis are more common in women and more women are disabled from arthritis. Osteoarthritis (OA) is the degenerative disease of cartilage and joints with a slow progressive non-deforming course. The joints most affected are usually the hands and large weight-bearing joints. Incidence. Arthritic changes are very common. Twenty-four percent of women age 54-75 and more than half of women age 75 and older report symptomatic OA. In 2003, in the USA approximately 46 million individuals reported arthritis, costing approximately $81 billion in health care and lost work. In the Third National Health and Nutrition Examination Survey (NHANES III), women had more carpal deformities than men. Almost one-quarter of women reported first carpal-metacarpal deformities, compared to 10% of men. Fifty-eight percent reported Heberden's nodes, 29.9% had Bouchard's nodes, and 18.2% had first carpal-metacarpal deformities. Painful hand arthritis incidence increased with age and caused difficulty dressing, lifting, and eating. In the NHANES III, knee arthritis was also very common. Thirty-seven percent of adults reported knee osteoarthritis. Significantly more women reported knee arthritis than men. Knee replacement occurred in 1.5%. Adults with symptomatic knee OA were more likely to use non-steroidal anti-inflammatory agents, use canes, and have slower gaits. A survey in the UK showed that approximately 9% of all individuals reported knee OA. Hip arthritis is prevalent but reported more by men than women. Approximately 15% of survey participants older than age 60 reported hip pain. More minority women reported hip pain than men.