Risk factors for osteoarthritis -: Understanding joint vulnerability
Risk factors for osteoarthritis -: Understanding joint vulnerability
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DOI：
10.1097/01.blo.0000144971.12731.a2
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发表时间：
2004-10-01
影响因子：
4.2
通讯作者：
Felson, DT
中科院分区：
文献类型：
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作者：
Felson, DT
当保护接头的结构失效时，就会发生接头损坏。由于骨关节炎包括终末期关节损伤，我认为疾病的风险因素最好被理解为关节保护器受损，增加关节脆弱性，或者是关节负荷过大，导致受伤。我使用这一范式回顾了当前的知识，将因素分为关节易损性增加的因素(排列不良、肌肉无力、遗传和种族倾向、衰老)和导致过度负荷的因素(肥胖；某些体育活动)。骨关节炎和软骨丢失可以在没有疼痛的情况下发生。这篇综述分别关注与骨性关节炎患者疼痛相关的因素。为了确定骨关节炎的疼痛来源，最近的研究比较了有疼痛和无疼痛的骨关节炎患者的磁共振成像结果，重点关注已知的具有伤害性神经支配的结构。那些有疼痛的人更有可能有积液，骨髓损害，滑膜肥大，以及关节周围的肌腱炎和滑囊炎。这篇综述以关节易损性和负荷为框架，为理解骨关节炎的危险因素创造了一个新的范式，并分别侧重于疼痛来源的新兴研究领域。
Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to injury. I review current knowledge using this paradigm, separating factors into those increasing joint vulnerability (malalignment, muscle weakness, genetic and ethnic predispositions, aging) and those that cause excessive loading (obesity; certain physical activities). Osteoarthritis and cartilage loss can occur without pain. This review focuses separately on factors associated with pain in those with osteoarthritis. To identify sources of pain in osteoarthritis, recent studies have compared magnetic resonance imaging findings of people with osteoarthritis with and without pain, focusing on structures known to have nociceptive innervations. Those with pain are more likely to have effusions, bone marrow lesions, synovial hypertrophy, and tendinitis and bursitis around the joint. This review creates a new paradigm for understanding risk factors for osteoarthritis, using joint vulnerability and loading as a framework and focuses separately on the emerging investigative area of sources of pain.