Perhimpunan Reumatologi Indonesia
Indonesian Rheumatology Association
Calcification of Joints or Osteoarthritis

Calcification of Joints or Osteoarthritis


Calcification of the joints in question is osteoarthritis. What is osteoarthritis (OA)? Osteoarthritis is a chronic disease that affects the joints and bones around these joints. In the past, OA was considered a degenerative disease, or a disease of the elderly due to wear and tear on the joints, but nowadays it is known that through research it turns out that apart from wear, there is an inflammatory process that affects the damage to the joints, even though the inflammation that occurs is not as great as other arthritis diseases. such as rheumatoid arthritis.

Besides being caused by wear, osteoarthritis can also be caused by trauma or as a result of other joint diseases (secondary). The cartilage between the joints serves as a cushion when the joint is worn, but because this part is damaged, the bone surfaces in the joint collide with each other, causing pain, swelling and stiffness.

Figure 1. Cartilage damage that occurs in osteoarthritis

Clinical symptoms

The complaint felt by OA patients is pain in the joints, especially joints that support body weight (such as the knee or hip joints). Pain is mainly felt after exertion using these joints, and decreases with rest.

Figure 1. Cartilage damage that occurs in osteoarthritis

Clinical symptoms

The complaint felt by OA patients is pain in the joints, especially joints that support body weight (such as the knee or hip joints). Pain is mainly felt after exertion using these joints, and decreases with rest.

Figure 2. Pain in the knee after activity

Sometimes there is a feeling of stiffness in the joint in the morning after waking up, lasting less than 30 minutes. This stiffness will get better after moving it for a while. When moved, you can hear a crepitus “crack” sound. After some time, the disease can worsen so that you also feel pain when you are resting. Pressure on certain parts around the painful joint will hurt. Joint motion is also limited due to pain.

There is no laboratory test that can confirm the diagnosis of OA, but radiological examinations ( X-rays ) can help, although the results are often not consistent with the patient’s symptoms. X-rays can show a narrowed joint gap, small bones (osteophytes) and sclerosis (calcification) occur around the affected joint.

OA risk factors

Old age is a risk factor for OA. Almost everyone over the age of 70 experiences this OA symptom, with varying degrees of pain. Before the age of 55 years the ratio of OA in men and women is comparable, but at the age above 55 years it is more in women.

Other risk factors are family history of OA, being overweight, work that requires squatting or kneeling for more than 1 hour / day. The work of lifting goods, climbing stairs or walking long distances is also a risk.

Sports that are traumatized to a joint such as football, basketball or volleyball also increase the risk of OA. Several other diseases that can cause secondary OA include rheumatoid arthritis, gout, hemophilia.


Osteoarthritis cannot be cured. This disease usually gets worse with age. But OA complaints can be controlled so that OA sufferers can move as usual and carry out daily activities without pain. Some medications can help slow down the damage, reduce or eliminate pain. Furthermore, if the pain remains even though you have undergone all treatment procedures, the last option is surgery. Inserting a prosthetic joint in the damaged joint can help patients who are not responding to therapy.

Non Pharmacological Therapy:

Education : first of all people with OA must first understand what is happening to their joints, why the pain occurs and what needs to be done, so that OA treatment can be successful. During activity, pain is felt and if the pain rest disappears, so that many sufferers choose to remain silent, do as little as possible doing activities so as not to hurt, this is not right because the muscles will become weak if rarely used, then the load to the joints will become heavier and when walking / getting up from sitting the pain gets worse. OA patients must try to be able to do daily activities, exercise and not be a burden to those around them, therefore education is very important in handling this OA disease.

In addition, sufferers must be careful using “ stelan” drugs or several kinds of “herbal medicine” which are sold freely with the promotion of “ to relieve rheumatism or gout ” The mixture contained in these medications can sometimes be dangerous for patients who are taking them. Side effects that occur are myopic eyes, porous bones, increased blood pressure, stomach ulcers and some even vomiting blood, kidney disorders and even fatal and causing death. Avoid using drugs like this.

Compress : If the joint is swollen, then the choice is cold compresses, and if it is resolved or the stiffness is over, the choice is warm compresses

Maintain the ideal body weight : It is important to pay attention to weight. If the excess BB must be lowered until the ideal BB. Excess weight will become a burden on the joints that support the body, making it even more painful.

A balanced diet : There are many myths circulating in society that eating green vegetables or nuts can cause joint pain, which is not true. Vegetables and nuts do not cause joint pain. There are no certain foods that cause pain in OA, but eating too much so that weight gain will increase pain, because it increases load on the joints to support body weight.

Lifestyle changes : Avoid positions or situations that cause trauma to the joints such as squatting, jumping, running, going up and down stairs too often or standing too long. & nbsp; Continue to carry out daily activities. If pain occurs, rest for a while, overcome the pain and return to activity. If your job causes pain, then you have to make adjustments to the job, for example, if you cook in the kitchen and when you stand for a long time, you experience pain, try to prepare it in a sitting position, so you don’t stand too long in the kitchen. Another example, if you usually wash clothes in a squatting position, then use a short chair to sit while washing so that it can reduce trauma to the knee.

Exercise using the muscles, especially the thigh muscles for those with OA in their knees is a good therapy. The method of exercise is in a lying position on your back then lift your straight leg (knees not bent) as high as 30 degrees then hold it for a count of 8 (10 seconds) then lower it and switch to the other leg. Do it alternately for several times. This exercise can strengthen the thigh muscles if done repeatedly several times a day with an increasing number gradually from day to day.

Figure 3. Thigh strengthening exercises

Another exercise is putting a towel under the knee, then lying on your back or sitting, pressing the towel by tightening your thigh muscles then holding it for 8 counts (10 seconds) then relaxing again, alternating left and right thighs . This exercise is done in stages and the frequency increases.

Figure 4. Towel practice

Exercise : The recommended exercise options for patients with OA are swimming and cycling, both of these sports do not use body weight, thereby reducing joint pain. If it is not possible for both sports then walking on a level and level place can be done and adjusted to the abilities of each patient.

Figure 5. Cycling is not only sport but also recreation

Assistive devices: Using joint aids such as a cane, walker and “decker” or a protective device for the joints can assist in carrying out activities. Consult with your doctor about the choice of tools that are right for the OA condition you are suffering from.

Pharmacological Therapy:

Paracetamol: is a fairly safe drug option for treating OA, except for those who are allergic to it. Medicines known as fever-reducing tablets have the effect of reducing pain so they can be used in OA. OA patients need to receive pain relief for a certain time so they can return to their activities, do exercises on their muscles so that the muscles become strong and reduce the burden on their joints.

Non-steroidal anti-inflammatory drugs: The use of these drugs must be in consultation with a doctor. The side effects of this class of drugs mainly affect the stomach, kidneys and heart, therefore, before use, you should consult a doctor. This class of drugs can reduce inflammation that occurs in the joints and surrounding areas, so that the pain will be much less.

Medicines supplements: glucosamine, chondrotin, diacerin and capsaicin etc., are supplements for OA that are widely found in the community. Even though it is relatively safe, you should also consult with your doctor about the benefits, how long it can be used and what effects should be considered.

Hyaluronic injection: This drug is given as a direct injection into the joint cavity, which acts as a lubricant and increases joint fluid. Its use must be careful and should only be done by doctors who are skilled at injecting it, because if it is not correct or less sterile it will be dangerous for the patient. There are several types of drugs with different viscosities so that the injection is once, or 2 to 5 injections once a week apart.

Corticosteroid injections: This drug can be used in conditions of inflamed and swollen joints. The doctor will inject this drug after first removing excess fluid from the swollen joint, its function as an anti-inflammatory. The use of this drug must also be careful a maximum of 3 times a year, because if it is too frequent it can result in damage to the joints themselves (steroid arthropathy).

Surgical therapy

Surgery or surgery is an alternative therapy for people with OA who have not responded to pharmacological or non-pharmacological therapies above. Some of the actions that can be taken include:

– Arthroscopy: uses a small tool that is inserted into the joint cavity to clean the damaged cartilage

– Synovectomy: surgery to treat inflamed joint tissue

– Osteotomy: surgery performed on one part of the bone so that the position and position is better and reduce the patient’s pain.

– Joint replacement: surgery replaces the damaged joint with a new joint made of metal.

By: dr. Laniyati Hamijoyo SpPD-KR, MKes

Division of Rheumatology, Department of Internal Medicine

Faculty of Medicine, University of Padjadjaran / Hasan Sadikin Hospital

Bandung / West Java