Crepitus
Crepitus is the grating, cracking sound like popping knuckles, which is reported by the patient. The sound is heard when the joint is used after a period of rest, for instance, extending the knee joint to stand up.
Although this symptom as first reported by the patient is liable to subjective interpretation. It may be a simple popping or the doctor can take it as a clinical manifestation of a latent osteoarthritis and order further investigations. However, research (2) shows a significant relation between crepitus being a harbinger for undiagnosed osteoarthritis. It is most often seen affecting the knee joint. The crepitus can be simply explained as a result of excessive friction between the bones due to loss of intervening joint space lined by synovial fluid as a lubricating agent. As explained below, osteoarthritis is also marked by the formation of bony outgrowths. These outgrowths are irregular bumps on the bones. The increased friction may be due to these spurs rubbing together or with the surrounding structures.
Bony spurs
The body compromises the cartilage loss at the joint by increasing the bone growth at the joint. This results in the formation of bony outgrowths or spurs.
A classical sign of osteoarthritis in the joints of fingers results in the formation of such nodes. If it affects the distal joint in the fingers, it is called Heberden’s nodes. The proximal joint in the finger may also get involved, resulting in formation of nodes called Bouchard’s nodes. These are small bony outgrowths which cause the fingers to appear thick externally. Pain, stiffness, and lack of mobility are also marked at these nodes. Especially in fingers, the fine motor skills are gravely impaired.
Sleep deprivation and depression
Psychological disturbances are an inevitable symptom of a long term disease like osteoarthritis. Episodes of pain during sleep can cause harm to sleep-wake cycles of the patients.
Similarly, there is an immense stress related to the disease itself, its progression and worsening and also about the lifestyle impediments that it causes. The limited mobility and inability to tend to fine motor skills can not only cause the patient to give up activities that employ these areas of skills, but also lead to dropout from work. All this can lead to symptoms of depression.