What are the other Names for this Condition? (Also known as/Synonyms)
- Degenerative Osteoarthritis of Elbow
- Elbow Arthritis
- Inflammation of the Elbow Joint
What is Arthritis of the Elbow? (Definition/Background Information)
- Arthritis is a joint disorder characterized by an abnormal inflammation that affects one or more joints, within the body. Generally, arthritis increases with age. The majority of individuals who develop the condition begin experiencing pain and stiffness, in the affected joint or limb
- Arthritis of the Elbow affects the elbow joint; especially the cartilage, bone, soft tissue surrounding the joint, muscles, and tendon
- There are many causes of Arthritis of the Elbow. Major causes are: Degenerative osteoarthritis, post-traumatic arthritis, avascular necrosis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and gout (gouty arthritis)
There are several different types of arthritis. The most common types of Elbow Arthritis that may develop include:
- Degenerative Osteoarthritis of Elbow: It is a common type of arthritis. Osteoarthritis is characterized by a progressive degeneration of cartilage, bones, or synovial membrane, within the joint, usually over a prolonged time period
- Post-Traumatic Elbow Arthritis: It is also a common type of osteoarthritis. Post-Traumatic Elbow Arthritis is a progressive, degenerative disorder that may develop after a significantly traumatic injury to the elbow
- Avascular Necrosis of Elbow: Avascular Necrosis of Elbow occurs when blood flow to elbow joint is disrupted. This results in tissue damage (of both the bone and soft tissue surrounding the joints). Common causes of avascular necrosis include, chronic steroidal therapy, sickle cell disease, and trauma to the joint
- Rheumatoid Arthritis involving Elbow: Rheumatoid arthritis is an autoimmune systemic inflammatory condition that may affect the lining of joints, surrounding tissues, or organs, within the body
- Systemic Lupus Erythematosus causing Elbow Arthritis: Systemic lupus erythematosus is an autoimmune systemic inflammatory condition that occurs when an individual’s immune system creates antibodies that accidentally attack healthy tissues and organs within the body
- Gout involving the Elbow Joint: A complex type of inflammatory arthritis, gouty arthritis is a medical condition caused by a high level of uric acid within the blood. A gout attack occurs with the abnormal formation of crystallized uric acid, resulting in inflammation of the joints. Gout generally affects small joints of the foot. Involvement of elbow joint by gout, is not common
Who gets Arthritis of the Elbow? (Age and Sex Distribution)
- Individuals of all age, race, or ethnic groups, and belonging to any gender, may develop Arthritis of the Elbow
- However, a high percentage of individuals who develop Elbow Degenerative Arthritis causing a debilitating and progressive disorder, are middle-aged and elderly adults
- Young athletes, who sustain traumatic joint injuries while participating in rough or high-impact sports, may develop Post-Traumatic Elbow Arthritis
- Elbow Degenerative Osteoarthritis and Systemic Lupus Erythematosus causing Elbow Arthritis is more common in females
What are the Risk Factors for Arthritis of the Elbow? (Predisposing Factors)
Risk factors associated with Arthritis of the Elbow include:
- Age: Degenerative Osteoarthritis of the Elbow may develop in individuals of all ages, but is rarely diagnosed in individuals under the age of 40 years. However, since it is a gradually progressing disorder, the risk of developing this condition usually increases with age
- Gender: Degenerative Osteoarthritis of the Elbow and rheumatoid arthritis are more likely to develop in women. However, men have an increased risk of developing gouty arthritis
- Athletics: Individuals who sustain a elbow joint injury while participating in a rough or high-impact sports, such as football, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding, are prone to developing Post-Traumatic Elbow Arthritis
- Obesity: Excess body weight associated with obesity may cause abnormally increased pressure on the joints. This increases the risk for degenerative osteoarthritis, affecting the elbow
- Family history: Some arthritic disorders, such as rheumatoid arthritis, have a genetic prevalence. Those having an immediate family member or a relative with a history of rheumatoid arthritis condition, may be at an increased risk
- Smoking: Various studies have found that smoking is one of the key contributing factors for the development of rheumatoid arthritis
- Certain occupations: Individuals with certain occupations (like carpenters and painters), which require a set of repetitive physical movement/motion for prolonged periods, have an increased risk of developing Degenerative Osteoarthritis of the Elbow
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Arthritis of the Elbow? (Etiology)
Many different contributing factors exist, since there are several different types of arthritis. Some causes that may be associated with Arthritis of the Elbow include:
- Sports-related injury: Post-Traumatic Elbow Arthritis may develop in individuals who sustain a joint injury, while participating in rough or high-impact sports, such as football, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding
- Certain occupations: Individuals with certain occupations that require a set of repetitive physical movement/motion for prolonged periods, such as carpenters and painters, may be affected by Degenerative Osteoarthritis of the Elbow
- Family history: Some arthritic disorders, such as rheumatoid arthritis, have a genetic prevalence. Those having an immediate family member or a relative with a history of this condition, may be at risk
- Obesity: Excess body weight associated with obesity, may cause abnormally increased pressure on the joints
In all of the above cases, the cartilage tissue covering the joint is damaged, either due to inflammation (such as rheumatoid arthritis), or due to repeated stress/trauma (such as degenerative osteoarthritis). The thinning of cartilage causes bone-on-bone contact in the joints. Once the bones are rubbing on each other, it causes pain, stiffness, and abnormally restricted joint movement
What are the Signs and Symptoms of Arthritis of the Elbow?
Arthritis is a gradual progressive disorder that usually worsens over time. Common signs and symptoms associated with Elbow Arthritis include:
- Noticeable pain and tenderness (pain on touch)
- Swelling of tissue (due to inflammation) around the elbow joint
- Stiffness, decreased range of motion of the elbow joint
- Formation of bone spurs surrounding the elbow joint
How is Arthritis of the Elbow Diagnosed?
Diagnostic methods that a physician may use to help diagnose Arthritis of the Elbow include:
- Physical examination: A thorough physical examination of the elbow may be undertaken by the physician. In addition to this, a complete medical history will aid in arriving at the correct cause of Elbow Arthritis
- X-rays: X-rays are utilized to visualize images of the elbow. It can also help the physician rule out other possible causes of elbow discomfort
- Blood test: A blood sample is drawn from an artery or vein using a needle and taken to a laboratory for analysis. Blood tests such as complete blood count (CBC), rheumatoid factor (RF) levels, cultures of the joint fluid, lupus blood tests (SLE panel), help the healthcare provider arrive at a cause for Elbow Arthritis
- Fine needle aspiration (FNA) of joint fluid analysis: Occasionally, fluid may accumulate around a joint, which results in pain and disability. Analysis of this joint will provide clues regarding the cause of joint fluid accumulation
- Ultrasound imaging: An ultrasound imaging equipment uses high-frequency sound waves to generate a more detailed image of the elbow
- MRI and CT scan of the elbow joint: This helps assess the damage to the joint and surrounding tissue
- Arthroscopy: During this procedure a surgeon inserts a thin tube attached to a camera (a fibro-optic camera) into the joint, via a small incision on the skin of the joint. Visualizing the joint via a camera helps the healthcare provider arrive at a cause of Elbow Arthritis. Arthroscopy is considered to be a minimally invasive diagnostic tool
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Arthritis of the Elbow?
Arthritis is a progressive condition that gradually worsens over a long period of time. The complications from Elbow Arthritis include:
- Chronic pain and stiffness of the elbow joint, which may prevent individuals from performing their routine daily activities
- Some cases may cause permanent disability (frozen joints)
How is Arthritis of the Elbow Treated?
The treatment measures depend on the cause of Elbow Arthritis and these are grouped as non-surgical and surgical treatment methods. A healthcare provider may start with non-surgical treatment methods before adopting surgical procedures and techniques. However, in some cases, the healthcare provider may elect to use surgical treatment methods, if the symptoms or the condition, cannot be managed with conservative non-surgical methods.
Nonsurgical treatment measures that may help relieve pain and improve the range of motion of the elbow joint include:
- Rest: Any activity that aggravates the elbow condition further should be avoided. The physician usually advises to refrain from all such activities, until the symptoms stop
- Heat and ice: Applying a damp heated towel or ice to the elbow joint, can help reduce pain and swelling
- Splint or brace: Some type of padded splint or cast may be used to help keep the elbow joint in a stable position, especially while sleeping
- Non-steroidal anti-inflammatory medication: Oral medications, such as ibuprofen and naproxen, can help decrease pain and swelling in the elbow
- Corticosteroids: Oral steroidal medications, such as prednisone, may help decrease inflammation and increase motion range of the elbow
- Viscosupplementation therapy: The normally present fluid (synovial fluid) within a joint contains a material called hyaluronic acid. When a joint is affected by osteoarthritis, there is a reduction of hyaluronic acid level within the joint. This decreased acid level reduces the fluid’s ability to lubricate the joint. Viscosupplementation is a common and minimally invasive technique that is used in treating osteoarthritis. During this procedure, small doses of hyaluronic acid are injected into the elbow joint, to increase its lubrication and thereby relieve pain
- Cryotherapy: Cryotherapy is a non-invasive treatment method that uses extremely cold temperatures to reduce pain, inflammation, and swelling of the elbow joint. This method is not used commonly
- Physical therapy: After the signs and symptoms have decreased, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as flexibility, in the muscles
- Injection of steroids into the joints: Steroid injection into the joint helps in temporary relief of symptoms (such as pain), and in improving the range of motion. However, it is important to note that steroidal injections only provide a temporary relief and prolonged episodes of such injections, may injure the joints in the long run
Surgical treatment measures include:
- Elbow resection arthroplasty: Elbow resection arthroplasty is an arthroscopic surgical intervention technique that is used to repair an elbow joint
- Hemiarthroplasty: Hemiarthroplasty involves the partial removal of the elbow joint; specifically the head of the forearm bone called radial head, lower end of arm bone called humerus, or proximal portion ulna bone. The partially removed joint is then replaced by a prosthetic metal implant
- Total elbow arthroplasty: In total elbow arthroplasty, the elbow joint is completely removed. It is then replaced by a metal and plastic prosthetic implant. This surgical procedure is recommended, if the entire elbow joint is acutely affected by the inflammatory and degenerative joint disorder
How can Arthritis of the Elbow be Prevented?
Common recommendations to help prevent Arthritis of the Elbow are:
- Healthy body weight: Maintaining a healthy body weight can help reduce abnormal pressure within the joints, which may decrease the risk of arthritis
- Healthy diet: Individuals who consume a healthy diet regularly, may decrease their chances of developing Elbow Arthritis
- Use protective gear: Individuals who participate in high-risk sports activities (like football), should wear appropriate safety equipment to help prevent the possibility of injuring their elbows, or other joints
- Regular stretching exercise helps decrease the incidence of development of Arthritis of the Elbow
What is the Prognosis of Arthritis of the Elbow? (Outcomes/Resolutions)
- The long-term prognosis with arthritis depends on the specific type of inflammatory and degenerative disorder an individual develops, and the severity of the condition
- If the cause of Elbow Arthritis is detected early, and proper, aggressive treatment provided; then, the quality of life can be substantially improved. This also helps avoid any serious complications from arising in the elbow joint
- Degenerative Osteoarthritis of the Elbow is a debilitating disorder. A high percentage of individuals who develop this disorder may experience a gradual degeneration of their elbow joint, during their lifetime
Additional and Relevant Useful Information for Arthritis of the Elbow:
Fine needle aspiration (FNA) of joint fluid analysis procedure:
- A needle is inserted within the joint space and the accumulated fluid aspirated with a syringe, which is then sent to a laboratory for analysis
- The tests a laboratory may perform would include: Analysis of the type of cells present in the fluid, chemical composition of the fluid, and examination of the fluid under the microscope, for the presence of crystals
- If an infection is suspected as the cause for fluid accumulation at the joint, then a joint fluid culture may be performed, to remove fluid from the joint
One must be careful while adopting unproven and non-evidence based claims, such as copper bracelets and magnets, for treating joint disorders. Your healthcare provider is the best source for advice, on new methods of treatment.
What are some Useful Resources for Additional Information?
1330 W. Peachtree Street.; Suite 100 Atlanta, GA 30309
Phone: (404) 872-7100
Toll-Free: 1 (800) 283-7800
American Academy of Orthopaedic Surgeons (AAOS)
6300 North River Rd. Rosemont, IL 60018-4262
Phone: (847) 823-7186
Toll-Free: (800) 346-2267
Fax: (847) 823-8125
References and Information Sources used for the Article:
http://orthoinfo.aaos.org/topic.cfm?topic=A00222 (accessed on January 16, 2013)
http://www.mayoclinic.com/health/arthritis/DS01122 (accessed on January 16, 2013)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223/ (accessed on January 16, 2013)
http://www.nlm.nih.gov/medlineplus/arthritis.html (accessed on January 16, 2013)
http://www.cdc.gov/arthritis/ (accessed on January 16, 2013)
http://nihseniorhealth.gov/arthritis.html (accessed on January 16, 2013)
http://www.flu.gov/at-risk/health-conditions/arthritis/index.html (accessed on January 16, 2013)
http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118494.htm (accessed on January 16, 2013)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5939a1.htm (accessed on January 16, 2013)
Helpful Peer-Reviewed Medical Articles:
Morrey, B. F., & Adams, R. A. (1992). Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am, 74(4), 479-490.
Morrey, B. F. (1992). Primary degenerative arthritis of the elbow. Treatment by ulnohumeral arthroplasty. Journal of Bone & Joint Surgery, British Volume, 74(3), 409-413.
Morrey, B. F., Adams, R. A., & Bryan, R. S. (1991). Total replacement for post-traumatic arthritis of the elbow. Journal of Bone & Joint Surgery, British Volume, 73(4), 607-612.
Ogilvie-Harris, D. J., Gordon, R., & MacKay, M. (1995). Arthroscopic treatment for posterior impingement in degenerative arthritis of the elbow. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 11(4), 437-443.
Antuna, S. A., Morrey, B. F., Adams, R. A., & O'driscoll, S. W. (2002). Ulnohumeral arthroplasty for primary degenerative arthritis of the elbow. J Bone Joint Surg Am, 84(12), 2168-2173.
Porter, B. B., Richardson, C., & Vainio, K. (1974). Rheumatoid arthritis of the elbow: the results of synovectomy. Journal of Bone & Joint Surgery, British Volume, 56(3), 427-437.
Phillips, N. J., Ali, A., & Stanley, D. (2003). Treatment of primary degenerative arthritis of the elbow by ulnohumeral arthroplasty. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME-, 85(3), 347-350.