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Osteoarthritis of the Elbow

Article
Bone, Muscle, & Joint
Diseases & Conditions
Contributed byLester Fahrner, MD+1 moreOct 08, 2023

What are the other Names for this Condition? (Also known as/Synonyms)

  • Degenerative Joint Disease of the Elbow
  • Elbow Joint Osteoarthrosis
  • Elbow Osteoarthritis

What is Osteoarthritis of the Elbow? (Definition/Background Information)

  • Osteoarthritis is a painful joint disorder characterized by the progressive degeneration of the articular cartilage that covers the bone surface of joints. Over time, the cartilage of the joint wears down. Studies have indicated that osteoarthritis has a genetic component to it
  • Osteoarthritis of the Elbow is a gradual progressive degenerative disorder that affects the elbow joint(s). It is the most common type of arthritis affecting the elbow joint
  • Individuals who develop the condition begin to experience pain and stiffness in the elbow that usually increase with age
  • Treatment associated with Osteoarthritis of the Elbow includes both nonsurgical and surgical methods. The prognosis of the condition is good with treatment in a majority of individuals

Who gets Osteoarthritis of the Elbow? (Age and Sex Distribution)

  • Osteoarthritis of the Elbow may occur in individuals of all ages, races, ethnic groups, and belonging to any gender
  • A high percentage of individuals who develop this degenerative, debilitating, and progressive disorder are middle-aged to elderly women
  • Middle-aged men and young athletes who sustain traumatic joint injuries (while participating in rough or high-impact sports activities), are higher prone to developing osteoarthritis
  • Women (especially after menopause), are more likely to develop the degenerative condition than men

What are the Risk Factors for Osteoarthritis of the Elbow? (Predisposing Factors)

The risk factors for Osteoarthritis of the Elbow may depend on whether the condition is primary (caused by age-related wear and tear of the joint) or secondary (due to an underlying condition or disorder).

The risk factors for primary osteoarthritis may include:

  • Advancing age: Osteoarthritis is rarely diagnosed in individuals under 40 years old. However, since it is a gradually progressing condition, the risk of developing it usually increases with age
  • Women are more susceptible to the condition than men, especially after menopause
  • Individuals who sustain a joint injury while participating in rough/high-impact sports such as football, tennis, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding
  • Abnormal pressure on the joints due to excess body weight (obesity)
  • Repetitive stress on the joint associated with certain occupations, such as farming or construction-related work, can increase the risk

The risk factors for secondary osteoarthritis may include:

  • Prior joint injury or infection 
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Acromegaly
  • Hemochromatosis
  • Alkaptonuria
  • Secondary syphilis
  • Lyme disease
  • Ankylosing spondylitis 
  • Psoriatic arthritis
  • Avascular necrosis
  • Many of the autoinflammatory diseases, such as systemic juvenile idiopathic arthropathy, Behçets disease, and adult-onset Still’s disease
  • Hypermobility syndromes lead to increased range of motion at joints. This excessive mobility leads to increased wear and tear on cartilage, and subsequently to early onset secondary osteoarthritis
    • Some conditions are hereditary, such as Ehlers-Danlos syndrome, Marfan syndrome, Stickler syndrome, osteogenesis imperfecta, and others
    • Down’s syndrome, cerebral palsy, and disorders leading to poor muscle tone also lead to increased joint motion
  • Wilson’s disease: A copper transport disease with prominent liver and neurologic findings
  • Gout and pseudogout: Medical conditions caused by high levels of uric acid or calcium crystals in the joint spaces
  • Paget’s disease of bone: A rare, chronic bone disorder characterized by abnormal growth and deformity of the bones
  • Hypothyroidism: A medical condition characterized by the body’s inability to produce enough thyroid hormone
  • Individuals with poorly-controlled diabetes; a chronic medical condition characterized by excessive levels of sugar in blood
  • Genetic disorders that cause improper formation of the joints

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's 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 Osteoarthritis of the Elbow? (Etiology)

Currently, the underlying cause of osteoarthritis is unknown. However, the causes associated with Osteoarthritis of the Elbow include:

  • Any injury to the elbow joint while participating in sports such as football, tennis, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding
  • Repetitive stress on the elbow due to certain occupations, such as carpentry or painting
  • Obesity, causing abnormal pressure on the joints
  • Some arthritic disorders have a genetic prevalence: Individuals with an immediate family member or relative having a history of osteoarthritis may also develop this disorder
  • Progressive damage of the joint cartilage (due to various reasons) is a key factor. The cartilage damage initiated by a cause factor activates an inflammatory response, which leads to further joint destruction

What are the Signs and Symptoms of Osteoarthritis of the Elbow?

Osteoarthritis is gradual, degenerative disorder that usually worsens over time. Common signs and symptoms associated with Osteoarthritis of the Elbow include:

  • Noticeable pain, tenderness
  • Swelling
  • Stiffness, reduced mobility of the elbow joint
  • Formation of bone spurs around the elbow joint

How is Osteoarthritis of the Elbow Diagnosed?

Diagnostic methods that a physician may use to help diagnose Osteoarthritis of the Elbow include:

  • Physical examination: The physician will perform a thorough physical examination to determine if the individual has osteoarthritis. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis
  • X-ray of the elbow joint: X-rays use radiation in order to produce images of the elbow, which can help the physician rule out other possible causes for elbow discomfort
  • Various blood tests: A blood test is a routine test used to diagnose various diseases and conditions. During this test, a needle is used to take a blood sample that is withdrawn from an artery or vein. This blood sample is taken to a laboratory for analysis
  • Joint fluid analysis of elbow joint: Occasionally, fluid may accumulate around a joint. Analysis of this fluid will give clues regarding the cause of the joint fluid accumulation, which causes pain and disability. A needle is inserted into the joint space, and the accumulated fluid aspirated with a syringe. It is then sent to a laboratory for analysis, to determine:
    • The type of cells present in the fluid
    • Chemical composition of the fluid
    • The presence of crystals (examination of fluid under a microscope)
  • If an infection is suspected as the cause of accumulation of the joint fluid, then a joint fluid culture may be performed. The culture of joint fluid will confirm an infection of the elbow joint, as the cause of arthritis (termed infective arthritis)
  • Ultrasound imaging of elbow joint: The use of high-frequency sound waves to generate a thorough image of the elbow
  • CT, MRI scan of the elbow joint

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 Osteoarthritis of the Elbow?

Osteoarthritis is a progressive condition that gradually worsens over time. The complications of Osteoarthritis of the Elbow could include:

  • Chronic pain and stiffness within the elbow joint, which may prevent individuals from performing their daily routine activities
  • Permanent disability

How is Osteoarthritis of the Elbow Treated?

The treatment of Degenerative Osteoarthritis of Elbow includes nonsurgical and surgical methods. A healthcare provider may start with non-surgical treatment methods before adopting surgical procedures and techniques. These 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: A physician may prescribe some type of padded splint or cast, to help keep the elbow in a stable position, especially while sleeping
  • Non-steroidal anti-inflammatory medication: Medications, such as ibuprofen and naproxen, can help decrease the elbow pain and swelling
  • Topical non-steroidal medications have been shown to improve osteoarthritis at specific locations. Application twice a day is required for a month, then daily, to attain relief
  • Corticosteroid medications, such as prednisone, help provide temporary relief of symptoms and improve the range of elbow motion. Corticosteroids can be given systemically or injected directly into a specific affected joint. It is important to note that corticosteroid injections only give temporary relief. Repetition of such injections can ultimately lead to further joint injury
  • Viscosupplementation: Normal fluid within a joint contains a material called hyaluronic acid. When an elbow joint is affected by osteoarthritis, a reduction of hyaluronic acid level occurs within the joint. Such a decreased acid level will decrease the ability of the joints to lubricate. Viscosupplementation is a minimally-invasive technique that is commonly used, when treating osteoarthritis. During this procedure, small doses of hyaluronic acid are injected into the hand to relieve pain
  • Physical therapy: After the symptoms have decreased, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as provide flexibility, to the muscles

Surgical treatment measures include:

  • Elbow joint fusion: Joint fusion is a surgical technique that involves the removal of the arthritic part within the joint and fusing two surrounding bones together. The purpose of this procedure is to relieve pain, stabilize the joint, and regain some range of motion in the elbow
  • Total elbow arthroplasty: Total elbow arthroplasty is a surgical intervention tool in which the elbow joint is completely removed. The arthritic elbow joint that is removed is then replaced by a metal and plastic prosthetic implant. A physician will recommend this surgical procedure, if the degenerative disorder affects the entire elbow joint

How can Osteoarthritis of the Elbow be Prevented?

A few recommendations to help prevent Osteoarthritis of the Elbow include:

  • Individuals who maintain a healthy diet may decrease the chance of developing this condition
  • Some evidence exists that adherence to the Mediterranean diet leads to improvement in in osteoarthritis
  • Estrogen replacement therapy can decrease the incidence of Osteoarthritis of the Elbow after menopause, in women
  • Using correct posture and tools that decrease stress on elbow joints in the work place can decrease incidence of the elbow disorder, due to occupational causes
  • Proper treatment of gout and pseudogout
  • Prompt and adequate treatment of individuals with Paget’s disease
  • In individuals with hypothyroidism, a prompt treatment of the thyroidal condition
  • Proper treatment of diabetes
  • Maintaining a healthy body weight can help prevent abnormal pressure on the joints
  • Individuals, who participate in any high-risk sports, such as football and basketball, should wear appropriate safety gear to help prevent serious injuries to their joints

What is the Prognosis of Osteoarthritis of the Elbow? (Outcomes/Resolutions)

The long-term prognosis of osteoarthritis depends on the severity of this degenerative disorder.

  • If Osteoarthritis of the Elbow is detected early and proper aggressive treatment provided; then, the prognosis is good in a majority of individuals, if there are no serious complications
  • In general, without treatment measures, a high percentage of individuals who develop this condition, may experience a lifetime of gradual degeneration associated with this debilitating disorder

Additional and Relevant Useful Information for Osteoarthritis of the Elbow:

  • Arthritis of the elbow affects the elbow joint; especially the cartilage, bone, soft tissue surrounding the joint, muscle, and tendon

The following article link will help you understand arthritis of the elbow:

https://www.dovemed.com/health-topics/orthopedc-disorders/

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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