The role and importance of laboratory in diagnosis and differantial diagnosis of osteoarthritis

Abstract

Osteoarthritis (OA) is among the most frequent diseases in the population and a common cause of pain and disability in adults. Although there is an increasing body of evidence that inflammatory events may be involved in its pathogenesis, OA is still classified as a degenerative or non-inflammatory condition, in contrast to inflammatory arthropathies.

The main diagnostic methods in OA are still radiographic changes, which are only evident when disease is established. Thus biochemical markers would be ideal in order to diagnose OA in pre-radiological stages and to identify different subsets of OA.

Biochemical markers of OA may be useful in diagnosis; assessment of the disease activity; prediction of outcome; and evaluation of drugs effects. Many biomarkers have been proposed, in particular those reflecting cartilage and bone turnover and synovitis. Among these, cartilage oligomeric matrix protein, antigenic keratan sulphate, hyaluronan, YKL-40, type III collagen N-propeptide, and urinary glucosyl-galactosyl pyridinoline appear to be the most promising. However, serum or urinary determinations of these molecules are difficult to interpret adequately due to their complex metabolism.