Hypertrophic Arthritis

Hypertrophic bone changes represent the reaction of bone and joint structures to the wear and tear of life. They are more pronounced in certain types of individuals and are aggravated by continued local irritation of any character.

These changes rarely occur before the thirty-fifth year of age but are progressive thereafter. They may exist to a marked degree without clinical symptoms. Being the result of metabolic changes rather than the cause, their presence does not prohibit relief from such symptoms.

Osteoarthritis (OA)

Osteoarthritis (OA) is the most common form of arthritis. Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees.

With OA, the cartilage within a joint begins to break down and the underlying bone begins to change. These changes usually develop slowly and get worse over time.

Symptoms

• Pain
• Stiffness
• Tenderness
• Loss of flexibility 
• Grating sensation
• Bone spurs
• Swelling

Causes

A number of factors can play a part in developing Osteoarthritis.  

Age:

Osteoarthritis usually starts from the late 40s onwards. This may be due to bodily changes that come with aging, such as weakening muscles, weight gain, and the body becoming less able to heal itself effectively.

Gender:

For most joints, osteoarthritis is more common and more severe in women.

Obesity:

Being overweight is an important factor in causing osteoarthritis, especially in weight-bearing joints such as the knee and the hip.

Joint injury:

A major injury or operation on a joint may lead to osteoarthritis in that joint later in life. Normal activity and exercise don’t cause osteoarthritis, but very hard, repetitive activity or physically demanding jobs can increase your risk.

Joint abnormalities:

If you were born with abnormalities or developed them in childhood, it can lead to earlier and more severe osteoarthritis than usual.

Genetic factors:

The genes we inherit can affect the likelihood of getting osteoarthritis at the hand, knee or hip. Some very rare forms of osteoarthritis are linked to mutations of single genes that affect a protein called collagen. This can cause osteoarthritis to develop in many joints at an earlier age than usual.

Other types of joint disease

Sometimes osteoarthritis is a result of damage from a different kind of joint disease, such as rheumatoid arthritis or gout.

Indirect Factors

Diet:

Some people find that certain foods seem to increase or lessen their pain and other symptoms. However, your weight is more likely than any other specific dietary factors to affect your risk of developing osteoarthritis.

Weather:

Many people with osteoarthritis find that changes in the weather make the pain worse, especially when the atmospheric pressure is falling – for example, just before it rains. Although the weather may affect the symptoms of your arthritis, it doesn’t cause it.

Effects

OA may affect different parts of the body in different ways.

• Hips: Pain in the groin area or buttocks and sometimes on the inside of the knee or thigh.
• Knees: A “grating” or “scraping” feeling when moving the knee. 
• Fingers: Bony growths (spurs) at the edge of joints can cause fingers to become swollen, tender and red, sometimes with pain at the base of the thumb.
• Feet: Pain and tenderness in the big toe, with possible swelling in the ankles or toes.
• Pain, reduced mobility, side effects from medications and other factors associated with osteoarthritis can lead to health complications that are not caused by the disease itself.
• Obesity, Diabetes and Heart Disease: Painful joints, especially in the feet, ankles, knees, hip or back, make it harder to exercise. But physical activity is not only key to managing OA symptoms, it also can help prevent weight gain, which can lead to obesity. Being overweight or obese can lead to the development of high cholesterol, type 2 diabetes, heart disease and high blood pressure. 
• Falls: Having OA can decrease function, weaken muscles, affect overall balance, and make falls more likely, especially among those with OA in knees or hips. Side effects from pain medications, such as dizziness, can also contribute to falls.

How to diagnose Degenerative Arthritis (Hypertrophic or Osteoarthritis)

Imaging tests

• X-rays: Cartilage doesn't show up on X-ray images, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. An X-ray can also show bone spurs around a joint.
• Magnetic resonance imaging (MRI): An MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage. An MRI may be necessary to get a better look at the joint and surrounding tissues if the X-ray results do not clearly point to arthritis or another condition.

Lab tests

• Blood tests: Although there's no blood test for osteoarthritis, certain tests can help rule out other causes of joint pain, such as rheumatoid arthritis.
• Joint fluid analysis: Your doctor might use a needle to draw fluid that has been accumulated in the joints (called joint aspiration) for examination under a microscope to rule out other diseases.

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note(2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in  rating conditions listed under diagnostic code  5013 to 5024, inclusive.