SEARCH RESULTS FOR: Inflammatory-Versus-Degenerative-Joint-Disease

Inflammatory Versus Degenerative Joint Disease

1hr after waking Legend: Mechanism Sign/Symptom/Lab Finding Systemic immune activation occurs ↑ Inflammatory mediators circulate throughout the body Extra- articular involvement (e.g., skin, eyes, lung, heart, kidneys) ± abnormal inflammatory markers (CRP, ESR) & autoantibodi es (RF, ANA) Pathophysiology Complications Degenerative Joint Disease Abnormal mechanics or repetitive/excessive loading stresses the joints Joint structures degrade over time Movement (using the joint) exacerbates the mechanical forces that are wearing down the joint Pain with movement Pain relieved with rest Fragments of broken articular cartilage triggers a mild synovial (thin lining inside of the joint) inflammation that seeps fluid into the synovial membrane during inactivity Joints stiffen with rest Moving the joint physically pushes inflammatory fluid back into lymphatic vessels (body's clean- up system) within minutes Joint stiffness resolves within minutes of movement Published on www.thecalgaryguide.com Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Martin Atkinson* Catherine R Jarvis * MD at time of publication The weight- bearing joints (i.e., knee, hip, & lumbar/cervical facet joints) sustain the highest mechanical load & degeneration Distinguishing between Inflammatory and Degenerative joint disease Inflammatory Joint Disease Auto-immune attack of body tissues, due to failure of the body’s immune system to discriminate between self and non-self. Degenerative Joint Disease Repetitive, excess, or abnormal mechanical forces on joints over time, leading to physical breakdown of the joint. Authors: Yan Yu Reviewers: Jennifer Au Sean Spence Martin Atkinson* * MD at time of publication Within joints, severe synovial inflammation dilates local blood vessels, and causes the vessel endothelium to be more leaky. Accumulation of abundant inflammatory synovial fluid at rest or overnight Swelling stimulates joint nociceptors Pain with rest Moving the joint physically pushes fluid back into lymphatics, relieving the painful swelling. Pain relieved with motion Legend: Overnight fluid accumulation in the synovial membrane Morning stiffness Lots of fluid, takes more time (hours) to be reabsorbed by lymphatics Stiffness resolves after >1hr Blood carries heat and looks red Warm, Red, Swollen Joints Pathophysiology Mechanism Sign/Symptom/Lab Finding Inflammation is oftentimes systemic, not localized exclusively within the joint (i.e. in Rheumatoid arthritis, Lupus, etc) Extra-articular manifestations; positive inflammatory markers (CRP, ESR, RF, ANA) Motion (using the joint) exacerbates the mechanical forces that are wearing down the joint Fragments of broken articular cartilage triggers a mild synovial inflammation that seeps fluid into the synovial membrane during inactivity Pain with motion (relieved by rest) Joint stiffness after inactivity Moving the joint physically pushes inflammatory fluid back into lymphatics within minutes. Note: one big difference btw the two is the degree of joint inflammation (synovitis) present in the joint capsule Stiffness is short-lived, quickly relieved by movement Published November1,2012 on www.thecalgaryguide.com Larger, weight- bearing joints tend to bear the brunt of the mechanical forces Most commonly affects the knee, hip, and L/C-spine facet joints Complications" title="Legend: Inflammatory vs Degenerative Joint Disease: Pathogenesis & clinical findings Inflammatory Joint Disease The body’s immune system fails to discriminate between self & non-self Autoimmune cells attack body tissues ↑ Synovial (thin lining inside of joints) inflammation ↑ Inflammation dilates blood vessels & activates the endothelium (lining of blood vessels) ↑ Intercellular junctions open à "leaky" blood vessels Synovial fluid accumulates & causes joint edema (swelling) ↑ Blood flow carries heat to affected joint tissues Edema (swelling) Warmth Erythema (redness) Fluid builds in the synovial membrane overnight Morning joint stiffness Swelling activates joint nociceptors (damage alarms) Pain worse with rest Systemic immune activation occurs ↑ Inflammatory mediators circulate throughout the body Extra- articular (body tissues outside of joints) inflammatory damage ± ↑ Inflammatory markers (CRP, ESR) ± ↑ Auto- antibodies (RF, ANA) Lymphatic vessels (the body’s cleaning system) need ↑ time to reabsorb ↑ fluid that accumulated overnight Joint stiffness resolves ~1 hour after waking Movement (using the joint) pushes fluid into lymphatic vessels (the body’s cleaning system) Pain relieved with movement Degenerative Joint Disease Abnormal mechanics (e.g., poor posture, weak stabilizing muscles) Repetitive or excess stress on joints Weight bearing joints (knee, hip & lumbar/cervical facet joints) sustain the highest mechanical load & degenerate over time Fragments of articular (joint) cartilage trigger a synovial (thin lining inside of joints) inflammation Movement (using the joint) exacerbates the mechanical forces wearing down the joint Inflammation causes fluid to seep into the synovial membrane during inactivity Pain with movement Pain relieved with rest Joints stiffen with rest Movement (using the joint) pushes fluid back into lymphatic vessels (the body’s cleaning system) Joint stiffness resolves within minutes of movement Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Catherine R Jarvis Martin Atkinson* Glen Hazlewood* * MD at time of publication Published Nov 1, 2012; updated Feb 1, 2026 on www.thecalgaryguide.com Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Final slide is the 1st slide Legend: Inflammatory vs Degenerative Joint Disease: Pathogenesis & clinical findings Inflammatory Joint Disease Degenerative Joint Disease The body’s immune system fails to discriminate between self & non-self Autoimmune cells attack body tissues Abnormal mechanics (e.g., poor posture, weak stabilizing muscles) Repetitive or excess stress on joints ↑ Synovial (thin lining inside of joints) inflammation dilates blood vessels Systemic immune activation occurs ↑ Endothelium (lining of blood vessels) activation opens intercellular junctions (“leaky” blood vessels”) ↑ Inflammatory mediators circulate throughout the body Weight bearing joints (knee, hip & lumbar/cervical facet joints) sustain the highest mechanical load & degenerate over time Synovial fluid accumulates & causes joint edema (swelling) Edema (swelling) ↑ Blood flow carries heat to affected joint tissues Extra- articular (body tissues outside of ± ↑ Inflammatory markers (CRP, ESR) ± ↑ Auto- antibodies (RF, ANA) Fragments of articular (joint) cartilage trigger a synovial (thin lining inside of joints) inflammation Movement (using the joint) exacerbates the mechanical forces wearing down the joint joints) inflammatory Inflammation causes Warmth Pain relieved Erythema damage fluid to seep into the Pain with (redness) synovial membrane movement with rest during inactivity Fluid builds in the synovial membrane overnight Morning joint stiffness Lymphatic vessels (cleaners) need ↑ time to reabsorb ↑ fluid that accumulated overnight Joints stiffen with rest Joint stiffness resolves ~1 hour after waking Movement (using the joint) pushes fluid back into lymphatic vessels (cleaners) Swelling activates joint nociceptors (damage alarms) Pain worse with rest Movement (using the joint) pushes fluid into lymphatic vessels (cleaners) Pain relieved with movement Joint stiffness resolves within minutes of movement Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Martin Atkinson* Catherine R Jarvis * MD at time of publication Published on www.thecalgaryguide.com Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Inflammatory vs Degenerative Joint Disease: Pathogenesis & clinical findings Inflammatory Joint Disease Degenerative Joint Disease The body’s immune system fails to discriminate between self & non-self Auto-immune cells attack body tissues Abnormal mechanics (e.g., poor posture, weak stabilizing muscles) Repetitive or excess stress on joints ↑ Synovial (thin lining inside of joints) inflammation dilates blood vessels Systemic immune activation occurs ↑ Endothelium (lining of blood vessels) activation opens intercellular junctions (“leaky” blood vessels”) ↑ Inflammatory mediators circulate throughout the body Weight bearing joints (knee, hip & lumbar/cervical facet joints) sustain the highest mechanical load & degenerate over time Synovial fluid accumulates & leads to joint edema (swelling) ↑ Blood flow carries heat to affected joint tissues Swelling activates joint nociceptors (damage alarms) Fluid builds in the synovial membrane overnight Edema (swelling) Warmth Erythema (redness) Extra-articular (body tissues outside of joints) inflammatory damage ± ↑ Inflammatory markers (CRP, ESR) & auto- antibodies (RF, ANA) Movement (using the joint) exacerbates the mechanical forces wearing down the joint Pain with movement Pain relieved with rest Pain worse with rest Morning joint stiffness Movement (using the joint) pushes fluid into lymphatic vessels (cleaners) Lymphatic vessels (cleaners) need ↑ time to reabsorb ↑ fluid overnight Pain relieved with movement Joint stiffness resolves ~1 hour after waking Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Martin Atkinson* Catherine R Jarvis * MD at time of publication Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Fragments of articular (joint) cartilage trigger a synovial (thin lining inside of joints) inflammation Inflammation causes fluid to seep into the synovial membrane during inactivity Joints stiffen with rest Movement (using the joint) pushes inflammatory fluid back into lymphatic vessels (cleaners) Joint stiffness resolves within minutes of movement Published on www.thecalgaryguide.com Inflammatory vs Degenerative Joint Disease: Pathogenesis & clinical findings Inflammatory Joint Disease The body’s immune system fails to discriminate between self and non-self Auto-immune cells attack body tissues ↑ Synovial (thin lining inside of joints) inflammation dilates blood vessels ↑ Endothelium (lining inside of blood vessels) permeability Synovial fluid accumulates & leads to joint edema (swelling) Systemic immune activation occurs ↑ Inflammatory mediators circulate throughout the body Extra-articular involvement (body tissues outside of joints) Elevated inflammatory markers (CRP, ESR) & auto- antibodies (RF, ANA) Degenerative Joint Disease Abnormal mechanics (e.g., poor posture, weak stabilizing muscles) Repetitive/excess stress on joints Weight bearing joints (knee, hip & lumbar/cervical facet joints) sustain the highest mechanical load & degenerate over time Movement (using the joint) exacerbates the mechanical forces wearing down the joint Pain with movement Pain relieved with rest Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Martin Atkinson* Catherine R Jarvis * MD at time of publication Swelling activates pain-sensitive joint nociceptors (damage alarms) Pain worse with rest Joint movement pushes fluid into lymphatic vessels (body's clean-up system) Pain relieved with movement Legend: ↑ Blood flow carries heat to affected joint tissues Edema (swelling) Warmth Erythema (redness) Fluid gradually builds in the synovial membrane overnight Morning joint stiffness Lymphatic vessels (body's clean-up system) need ↑ time to reabsorb ↑ fluid that accumulated overnight Joint stiffness resolves ~1 hour after waking Fragments of articular (joint) cartilage trigger a synovial (thin lining inside of joints) inflammation Inflammation causes fluid to seep into the synovial membrane during inactivity Joints stiffen with rest Moving the joint physically pushes inflammatory fluid back into lymphatic vessels (body's clean-up system) Joint stiffness resolves within minutes of movement Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published on www.thecalgaryguide.com JOINT DISEASE: Inflammatory vs. Degenerative Inflammatory Joint Disease The body’s immune system fails to discriminate between self and non-self Auto-immune cells attack body tissues ↑ Synovial (thin lining inside of the joint) inflammation dilates blood vessels ↑ Endothelium (inner lining of blood vessels) permeability Synovial fluid accumulates & leads to joint edema (swelling) ↑ Blood flow carries heat to affected joint tissues Swelling activates pain-sensitive joint nociceptors (damage alarms) Fluid accumulates progressively in the synovial membrane overnight Edema (swelling) Warmth Inflammatory pain worse with rest Morning joint stiffness Erythema (redness) Joint movement physically pushes fluid back into lymphatic vessels (body's clean-up system) Lymphatic vessels (body's clean-up system) need ↑ time to reabsorb the ↑ fluid that accumulated overnight Inflammatory pain relieved with activity Joint stiffness resolves > 1hr after waking Legend: Mechanism Sign/Symptom/Lab Finding Systemic immune activation occurs ↑ Inflammatory mediators circulate throughout the body Extra- articular involvement (e.g., skin, eyes, lung, heart, kidneys) ± abnormal inflammatory markers (CRP, ESR) & autoantibodi es (RF, ANA) Pathophysiology Complications Degenerative Joint Disease Abnormal mechanics or repetitive/excessive loading stresses the joints Joint structures degrade over time Movement (using the joint) exacerbates the mechanical forces that are wearing down the joint Pain with movement Pain relieved with rest Fragments of broken articular cartilage triggers a mild synovial (thin lining inside of the joint) inflammation that seeps fluid into the synovial membrane during inactivity Joints stiffen with rest Moving the joint physically pushes inflammatory fluid back into lymphatic vessels (body's clean- up system) within minutes Joint stiffness resolves within minutes of movement Published on www.thecalgaryguide.com Authors: Yan Yu Mackenzie Trpcic Reviewers: Jennifer Au Sean Spence Martin Atkinson* Catherine R Jarvis * MD at time of publication The weight- bearing joints (i.e., knee, hip, & lumbar/cervical facet joints) sustain the highest mechanical load & degeneration Distinguishing between Inflammatory and Degenerative joint disease Inflammatory Joint Disease Auto-immune attack of body tissues, due to failure of the body’s immune system to discriminate between self and non-self. Degenerative Joint Disease Repetitive, excess, or abnormal mechanical forces on joints over time, leading to physical breakdown of the joint. Authors: Yan Yu Reviewers: Jennifer Au Sean Spence Martin Atkinson* * MD at time of publication Within joints, severe synovial inflammation dilates local blood vessels, and causes the vessel endothelium to be more leaky. Accumulation of abundant inflammatory synovial fluid at rest or overnight Swelling stimulates joint nociceptors Pain with rest Moving the joint physically pushes fluid back into lymphatics, relieving the painful swelling. Pain relieved with motion Legend: Overnight fluid accumulation in the synovial membrane Morning stiffness Lots of fluid, takes more time (hours) to be reabsorbed by lymphatics Stiffness resolves after >1hr Blood carries heat and looks red Warm, Red, Swollen Joints Pathophysiology Mechanism Sign/Symptom/Lab Finding Inflammation is oftentimes systemic, not localized exclusively within the joint (i.e. in Rheumatoid arthritis, Lupus, etc) Extra-articular manifestations; positive inflammatory markers (CRP, ESR, RF, ANA) Motion (using the joint) exacerbates the mechanical forces that are wearing down the joint Fragments of broken articular cartilage triggers a mild synovial inflammation that seeps fluid into the synovial membrane during inactivity Pain with motion (relieved by rest) Joint stiffness after inactivity Moving the joint physically pushes inflammatory fluid back into lymphatics within minutes. Note: one big difference btw the two is the degree of joint inflammation (synovitis) present in the joint capsule Stiffness is short-lived, quickly relieved by movement Published November1,2012 on www.thecalgaryguide.com Larger, weight- bearing joints tend to bear the brunt of the mechanical forces Most commonly affects the knee, hip, and L/C-spine facet joints Complications" />