Osteoarthritis is caused by the degeneration of the cartilage surface in the knee joint. This degeneration affects the shape, structure, and function of the joint bones, including other bones near the knee joint.
Normally, once the cartilage surface of the knee joint deteriorates, it cannot be restored to its original condition. The symptoms gradually worsen over time. If not treated to slow down the degeneration, eventually surgery to replace the knee joint surface may be required.
‘Symptomatic’ Stages of Osteoarthritis
- Stage 1 is the stage where the cartilage surface begins to be damaged but inflammation has not yet occurred. The damage to the joint surface causes the production of a biomarker called Urine CTX-II, which can be detected in urine. If detected and treated until the body stops producing this biomarker, it is considered effective treatment that can slow disease progression.
- Stage 2 is the stage where the synovial membrane becomes inflamed at the cellular level. Treatment focuses on oral or injectable medications to reduce inflammation, relieve pain, and delay the progression of cartilage degeneration.
- Stage 3 is the stage where the joint structure has changed. Treatment aims to strengthen the muscles to reduce pain, as the cartilage degeneration can no longer be stopped.
Who Should Be Screened for Osteoarthritis?
- People aged 50 years and older
- Those with chronic knee pain
- Those found to have bone spurs
- Those experiencing stiffness in the knee joint in the morning upon waking, lasting no more than 30 minutes
- Those who hear a crunching sound when moving the knee due to friction of the inner joint lining or thickening tendons, or from rough cartilage at the end of the bone
Advantages of Diagnosing Osteoarthritis by Urine CTX-II Test
Screening for osteoarthritis by detecting the biomarker Urine CTX-II in urine is a good indicator of joint abnormalities from the early stage of the disease or the stage before pain occurs. It is not only for knee joint degeneration but also includes hip joints and other large joints.
Symptoms in the early stage or stage 1 cannot be detected by X-rays, ultrasound, MRI, or other methods. Therefore, if Urine CTX-II is not tested in urine, the opportunity to start treatment at the earliest stage, which is the most effective, will be missed.
Other diagnostic methods detect the disease only when it has progressed to the inflammatory stage or stage 2, when patients begin to experience pain and the disease cannot be completely cured.
Osteoarthritis may not be life-threatening but can cause significant suffering. Regular diagnosis and screening before symptoms appear help detect abnormalities early and allow for better treatment outcomes.
Dr. Kobsak Udomdej
Orthopedic Surgery Specialist
Muscle, Bone, and Joint Center Phyathai Nawamin Hospital
