The sound of crackling
Crepitus is the patient-reported grating, cracking sound resembling breaking knuckles. The sound is heard when the joint is used following a period of repose, such as when the knee joint is extended to stand up.
Although the interpretation of this symptom as initially reported by the patient is subjective. It may be a simple cracking, or the doctor may interpret it as a symptom of latent osteoarthritis and order additional tests. However, research (2) demonstrates a strong correlation between crepitus and undiagnosed osteoarthritis. It most commonly affects the knee joint. The crepitus is caused by excessive friction between the bones as a result of the loss of intervertebral joint space lined with synovial fluid as a lubricant. As described below, osteoarthritis is also characterized by the development of bony protrusions. These protrusions are irregular bone nodules. The increased friction could be the result of these spurs rubbing against one another or the adjacent structures.
calcified spurs
By enhancing bone growth at the joint, the body compensates for cartilage degeneration. This results in the formation of spurs or bony outgrowths.
The formation of these nodes is a classic indication of osteoarthritis in the finger joints. It is known as Heberden’s nodes when it affects the distal joints of the digits. The proximal joint of the finger may also be affected, leading to the formation of Bouchard’s nodes. These are small bony projections that make the digits appear externally thick. At these nodes, pain, rigidity, and lack of mobility are also evident. Fine motor skills, specifically in the digits, are severely impaired.
Lack of sleep and depression
Long-term conditions, such as osteoarthritis, invariably result in psychological disturbances. Pain episodes during sleep can disrupt the sleep-wake cycles of patients.
Similarly, there is a great deal of tension associated with the disease itself, its progression and worsening, and the lifestyle restrictions it causes. The patient’s limited mobility and inability to care for fine motor skills can lead to not only the abandonment of activities requiring these skills, but also the abandonment of employment. All of this can result in depressive symptoms.
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