Elbow arthritis is a term that covers a broad range of medical conditions affecting the elbow joint. Perhaps the most common forms of elbow arthritis are osteoarthritis and rheumatoid arthritis. Other forms of arthritis which can affect the elbow joint include gout, psoriatic arthritis and juvenile arthritis.
Common symptoms are inflammation, pain and swelling of the joint, as well as difficulty moving the elbow. This condition can be extremely painful and inconvenient. It can make it difficult to carry out everyday tasks such as bending or straightening the joint.
Treatment of early stage elbow arthritis usually involves pain management of the condition and reducing the rate of progression of the disease. In its more advanced stages, however, there are surgical procedures that can be used to treat the disease.
Probably the most common form of elbow arthritis is rheumatoid arthritis(RA). This is an autoimmune form of arthritis. The patient’s immune system attacks the linings of the elbow joint, called the synovia. As the linings swell in response to the attacks, the space in the joint becomes narrower, making joint movement more difficult and reducing range of motion.
However, rheumatoid arthritis does not usually stop at the joint linings. It eventually also attacks and destroys the bones and soft tissues of the joint.
In most cases, RA attacks both the left and right elbows simultaneously. It also attacks nearby joints such as the wrists, hands and shoulders. As a general rule of thumb, RA tends to affect multiple joints simultaneously. It is rare for one joint to be affected in isolation.
The second most common form of elbow arthritis is osteoarthritis (OA).This form of arthritis attacks the slick cartilage coverings over the ends of bones. The function of healthy cartilage is to enable the bone ends to move smoothly over each other without the bones themselves coming into direct contact.
OA causes the bone cartilage to deteriorate and become thinner so that the bones of the elbow eventually come into direct contact with each other. This causes pain whenever the patient tries to move the elbow.
OA is itself sometimes the result of an earlier injury to the elbow that damages bone cartilage. If this happens, it can start a process of cartilage deterioration that can eventually lead to the development of osteoarthritis.
The main symptom of elbow arthritis is pain in the joint. However, the nature of the pain is variable depending on the type of arthritis:
Other symptoms of elbow arthritis include the following:
Diagnosis of this condition is usually based on a thorough physical examination of the elbow. This will include looking for the location of the elbow pain as well as any swelling or redness that may be present.
The doctor may ask about any previous elbow injuries the patient may have suffered. The goal will be to identify any previous injuries that may have led to arthritis.
In addition, the doctor will check for any reduction in the elbow range of motion. He or she will want to identify the positions of the elbow that are most painful.
In addition to the physical examination, the doctor may request an X-ray or (less frequently) an MRI scan. These will reveal whether the space of the joint is narrowing (a sign of RA) . Loose bone fragments may also show up in an X-ray and help the doctors to determine the type of arthritis that is present.
If the diagnosis is thought to be rheumatoid arthritis, your primary care doctor is likely to refer you to a specialist (rheumatologist).
In the early stages of elbow arthritis, a doctor will most likely opt for some or all of the following conservative treatment options:
If the elbow arthritis is advanced, or does not respond to the above treatments, doctors may suggest a surgical approach.
The ultimate choice will depend on the patient’s age, the type of arthritis that is present and how advanced it is. However, having said this, the following surgical options are available:
Under this procedure, the surgeon makes 2 or 3 small incisions in the elbow. He or she then uses tiny instruments to remove bone spurs, loose fragments of bone or a portion of the damaged synovial lining. This option is available as a potential treatment for either OA or RA.
This involves the removal of the damaged synovial lining. In some cases, the surgeon may also remove a portion of bone to allow room for greater joint range of motion. Synovectomies are often performed to combat RA in its early stages.
This is a frequent procedure for the treatment of OA. In it, the surgeon removes a portion of the bone of the elbow to prevent direct contact between the bones forming the joint.
This involves elbow replacement with an artificial joint . It is usually reserved for patients of at least 60 years of age or for those with advanced OA or RA.
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