What is the role of joint space loss in the pathogenesis of osteoarthritis (OA)?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In major weight-bearing joints of persons with osteoarthritis, a greater loss of joint space occurs at those areas experiencing the highest loads. This effect contrasts with that of inflammatory arthritides, in which uniform joint-space narrowing is the rule.

In the osteoarthritic knee, for example, the greatest loss of joint space is commonly seen in the medial femorotibial compartment, though the lateral femorotibial compartment and patellofemoral compartment may also be affected. Collapse of the medial or lateral compartments may result in varus or valgus deformities, respectively.

Krasnokutsky et al reported that the serum uric acid level can predict future joint space narrowing. In their study of 88 patients with medial knee osteoarthritis, over the course of 24 months, mean joint space narrowing of 0.31 mm occurred in patients with a serum uric acid level of less than 6.8 mg/dL (the solubility point for serum urate), compared with 0.90 mm in those with a serum uric acid level of 6.8 mg/dL or higher (P <  0.01). These authors suggest that serum uric acid levels may serve as a biomarker for progression of osteoarthritis. [27]


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