unit9-b.

1、Text B OsteoarthritisIntroduction to osteoarthritis 骨关节炎概论Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a “cushion” between the bones of the joints. Osteoarthritis is also known as degenerative arthritis. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common，affecting over 20 million people in the United States. Osteoarthritis o

2、ccurs more frequently as we age. Before age 45, osteoarthritis occurs more frequently in males. After age 55 years, it occurs more frequently in females. In the United States, all races appear equally affected. A higher incidence of osteoarthritis exists in the Japanese population, while South African blacks, East Indians，and Southern Chinese have lower rates. 骨性关节炎是一种由一个或多个关节软骨破坏和损伤引起的关节炎。软骨是一种能在关节的骨头之间充当“缓冲”作用的蛋白质。骨性关节炎又称为退行性关节炎。在100余种不同类型的关节炎中，骨关节炎是最常见的，它影响着超过2000万的美国人。随着年龄的增长，骨关节炎的发生率增高。在45岁

3、以前，骨关节炎在男性中更为常见。55岁以后，女性多发。在美国，所有种族都受到同样的影响。骨关节炎在日本发病率较高，南非黑人、东印度人和中国南部人群发病率较低。Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. Most cases of osteoarthritis have no known cause and are referred to as primary osteoarthritis. When the cause of the osteoarthritis is known, the condition is referred to as secondary osteoarthritis. Osteoarthritis is sometimes abbreviated OA.What causes osteoarthritis ?骨关节炎通常累及手、脚、脊柱和大的负重关节，如髋关节和膝关节。大

4、多数骨关节炎没有明确的病因，被称为原发性骨关节炎。有明确病因的骨关节炎被称为继发性骨关节炎，有时也被简称为骨关节炎。是什么原因导致骨性关节炎？Primary osteoarthritis, osteoarthritis not resulting from injury or disease, is mostly a result of natural aging of the joint( Fig. 9-2). With aging, the water content of the cartilage increases, and the protein makeup of cartilage degenerates. Eventually，cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced osteoarthritis, there is a total loss of the cartilage cushion between the bones of the join

5、ts. Repetitive use of the worn joints over the years can irritate and inflame the cartilage, causing joint pain and swelling. Loss of the cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs，also referred to as osteophytes) to form around the joints. Osteoarthritis occasionally can develop in multiple members of the same family, implying a hereditary (genetic) basis for t

6、his condition. 原发性骨关节炎是指无损伤或疾病导致的骨关节炎，主要是由关节的自然老化导致（图9-2）。随着年龄的增加，软骨由少量水分和退化的蛋白质组成。最终，软骨开始退化、剥落或形成微小的裂隙。在骨关节炎发病初期，关节软骨垫之间出现损失。长期磨损关节、重复使用可能会刺激软骨，导致关节疼痛和肿胀。软骨垫的丢失会导致骨头之间的摩擦，导致关节活动时疼痛和关节受限。软骨的炎症也会刺激新骨的形成（副产物，也被称为骨赘）在关节形成。骨关节炎有时可以在同一个家族的多个成员中发病，这意味骨关节炎有遗传（基因）倾向。Secondary osteoarthritis is a form of osteoarthritis that is caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at

7、 birth ( congenital abnormalities )，gout， diabetes, and other hormone disorders.继发性骨关节炎是由另一种疾病或致病条件引起的骨关节炎的一种形式。可导致继发性骨关节炎的病因包括肥胖、反复创伤或手术后关节结构改变、先天关节畸形（先天性异常）、痛风、糖尿病和某些激素异常。Obesity causes osteoarthritis by increasing the mechanical stress on the joint and therefore on the cartilage. In fact, next to aging, obesity is the most significant risk factor for osteoarthritis of the knees. The early development of os teoarthritis of the knees among weight lifters is believed to be in part due to their h

8、igh body weight. Repeated trauma to joint tissues (ligaments， bones, and cartilage) is believed to lead to early osteoarthritis of the knees in soccer players and army military personnel. Interestingly, studies have not found an increased risk of osteoarthritis in long-distance runners.肥胖会导致骨关节炎，增加关节承受力、磨损软骨。事实上，在衰老的过程中，肥胖是膝关节骨性关节炎最重要的危险因素。举重运动员超重是导致膝关节骨性关节炎发病早期的部分病因。足球运动员和军人膝关节骨性关节炎发病早期与关节组织（韧带、骨和软骨）的反复创伤有关。有趣的是，研究目前并没有发现长跑运动员发生骨关节炎的风险增加。Crystal deposits in the cartilage can cause cartilage deg

9、eneration and osteoarthritis. Uric acid crystals cause arthritis in gout, while calcium pyrophosphate crystals cause arthritis in pseudogout.晶体沉积在软骨中会引起软骨退变和骨关节炎。例如尿酸结晶可引起关节炎、痛风，焦磷酸钙晶体可引起假性痛风关节炎。Some people are born with abnormally formed joints (congenital abnormalities) that are vulnerable to mechanical wear, causing early degeneration and loss of joint cartilage. Osteoarthritis of the hip joints is commonly related to structural abnormalities of these joints that had been present since birth.一部分人是天生畸形关节（先天性异常），因此容易受到机械磨损，导致关节软骨早期退变和损失。髋关节骨性关节炎通常与出生时关节结构异常有关Hormone disturbances，such as diabetes and growth hormone disorders，are also associated with early cartilage wear and secondary osteoarthritis.激素紊乱如糖尿病、生长激素紊乱，也与早期的软骨磨损和继发性骨关节炎有关。What are osteoarthritis symptoms and signs ?骨关节炎的症状和体征是什么？Osteoarthritis is a disease of the joints. Unlike many other forms of arthritis that are systemic illnesses (conditions that affect multiple areas of the bo

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