Elbow Joint Arthritis

Arthritis is the loss of the cartilage lining the joint surface (articular cartilage). Normally this is a soft, glistening, smooth white tissue, which acts as a bearing surface to allow the joint to move freely. If the cartilage is damaged, the surface becomes rough and no longer glides. This causes pain and stiffness within the joint.

The most commonly affected joints are the hip and knee. The elbow is less commonly affected.

What causes it?

The primary cause of arthritis in the elbow is rheumatoid arthritis, a condition that affects joints and organs throughout the body.

Other causes include:

Trauma: If the elbow joint has been broken (fractured) at some point, the cartilage may have been damaged.

Instability: If the elbow has dislocated at any time the cartilage may have been damaged.

Idiopathic: Arthritis of unknown cause. It may be genetic (inherited) or may be due to heavy
manual work, but a specific cause is usually not found.

What are the symptoms?

Pain is usually the first complaint and may be difficult to precisely locate. The elbow may also stiffen with the first movement lost being extension (straightening). As the condition progresses, flexion (bending) is reduced, as is the ability to fully rotate the wrist. There may be a sensation of grinding or catching within the elbow. On occasion there may be crunching, which can be heard.

How is the diagnosis made?

The doctor will listen to the description of the symptoms and will examine the elbow. Plain x-rays are usually sufficient to make the diagnosis.

What is the initial treatment?

There is no cure for arthritis. If the cause is rheumatoid arthritis, a Rheumatologist will be involved to optimize the medication to control the condition. If one of the other causes is responsible then initial treatment consists of painkillers and anti-inflammatories. Exercises to try to maintain or improve the range of movement may help.

If the initial treatment does not work, what is next?

Corticosteroid injection into the elbow can be given as pain relief. The amount of benefit is variable, as is the duration, which may be as little as days or as long as months.

Arthroscopy and debridement in which an arthroscope is introduced into the elbow and the rough cartilage smoothed down also has variable results, with benefits as variable as those seen with injection, although usually longer lasting.

Elbow replacement, in which the arthritic elbow joint is replaced with a new one consisting of metal and plastic gives relief of pain in 90% of patients. The replacement may not give the full range of motion back however.

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