[Many paths converge in arthritis. Awareness of risk factors and illness mechanisms increase steadily].

Osteoarthritis does not deserve the term "degenerative joint disease", the course of the disease is characterized by dynamic changes in both synthesis and degradation of cartilage and other joint tissues. At the end stage all tissues of the joint are involved, not only the cartilage. In the early phases of the disease, changes in cartilage metabolism can be detected through assay of biomarkers in joint fluid, blood or urine. These changes evolve into macroscopic changes of fibrillation and loss of cartilage. Concomitantly, changes occur in other joint tissues and bone. The more advanced stages of change, as loss of joint space and osteophytes, may be detected by radiological examination. Osteoarthritis is a complex disease where genetic variations in several loci appear to interact with environmental factors to initiate and drive disease progression towards several different phenotypes. These may be recognized in different joint patterns, predominant inflammation or lack of inflammation, predominant loss of joint space or osteophytosis, etc. Increased occupational joint load, joint injuries and obesity are well recognized risk factors for osteoarthritis.