Rapidly destructive osteoarthritis is a rare type of arthritis that causes rapid and significant damage to joints. It most commonly affects the hip but can also affect other joints, such as the spine.

Osteoarthritis (OA) is a chronic and progressive disease that causes joint pain and inflammation. Usually, OA progresses slowly due to wear and tear, stress, or underlying diseases, but a minority of people experience rapid progression.

Researchers do not fully understand why some people get rapidly destructive OA. Injuries, infections, and other conditions may speed up the process, but doctors often cannot find an underlying cause.

Read on to learn more about rapidly destructive OA.

Hip X-rays on a lightbox following a test for rapidly destructive osteoarthritis.Share on Pinterest
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Rapidly destructive OA is a form of OA that progresses much more quickly than is typical.

OA is a type of joint damage that occurs due to wear and tear. As a person uses the joint throughout their life, the cartilage wears down, damaging the joint.

This process is usually a slow one, but in rapidly destructive OA, the damage happens in a much shorter period. Often, it develops in just a few months.

Doctors do not fully understand rapidly destructive OA. They have not defined any subtypes. Rapidly destructive OA most frequently affects the hip joint, so most research has focused on hip arthritis.

Rapidly destructive OA can affect other joints, too, such as the spine and knee. According to a 2020 paper, 1 in 7 people with knee OA experience rapid progression.

Researchers are still learning what causes rapidly destructive OA. Certain factors appear to raise the risk of rapid progression, but in many cases, the rapid progression is idiopathic. This means there is not a clear cause.

Some of the potential causes of rapidly destructive OA include:

  • Injury: Post-traumatic OA can progress faster than other forms of OA, causing rapid damage.
  • Septic arthritis: Septic arthritis occurs due to an infection. It can cause a joint to deteriorate rapidly.
  • Avascular necrosis: Avascular necrosis is the death of bone tissue or the joint due to problems with the surrounding blood vessels.
  • Crystal-induced arthropathy: Crystals deposited in the joint, often from gout, can cause rapid damage.
  • Amyloid arthropathy: Amyloid arthropathy causes the deposit of proteins in the joint, sometimes because of another disease, such as rheumatoid arthritis.
  • Medications: Some researchers believe that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) may have associations with rapidly destructive OA. Steroid injections inside joints may also have links with faster progression. However, more research is necessary to investigate this.

Rapidly destructive OA causes the same symptoms as OA but on an accelerated timeline.

Symptoms of OA include:

  • joint pain and stiffness
  • decreased range of motion in the affected joint
  • pain and difficulty with daily activities
  • symptoms that are worse in the morning or during exercise

Compared to OA, rapidly destructive OA progresses very rapidly, causing worse symptoms. Some signs a doctor might find on an imaging scan include:

  • missing articular cartilage
  • destruction of bone
  • joint effusion, which is a type of fluid accumulation

In some cases, a doctor may diagnose OA based on a person’s symptoms and a physical examination, particularly if the person is over age 45.

Imaging scans can help a doctor assess how far the condition has advanced. A doctor may recommend X-rays or an MRI scan to determine this.

Because rapidly destructive OA is rare, there are no standardized diagnostic criteria. However, most papers on the disease suggest that the disease rapidly progresses over just a few months, or in less than 1 year.

For example, in the case of rapidly destructive spinal OA, the disease may destroy the disk between vertebrae in months, rather than years or decades.

It is currently unclear how doctors can best treat rapidly destructive OA. If the condition has a known cause, such as an infection, treating that underlying infection may help slow the disease course.

Some research suggests the treatments that typically help with OA may speed up the progression of the condition in some people. This includes the use of NSAIDs and intra-articular steroid injections. However, studies have had mixed results, so more research is necessary.

To prevent bone loss, surgery may be an option. This can partially or completely replace the affected joint. Data suggests rapidly destructive OA responds as well to surgery as typical OA.

The outlook for people with rapidly destructive OA tends to be worse than for people with typical OA. The disease quickly destroys the joint, which may cause significant impairment and pain.

Additionally, although OA does not directly affect other aspects of health, it can make it difficult to continue healthy activities, such as exercise. Developing the condition and undergoing surgery may also impair mental health.

If a person has concerns about joint pain or other symptoms, or they feel persistent symptoms of depression or anxiety, they can speak with a doctor for support and treatment.

Rapidly progressive osteoarthritis (OA) causes symptoms similar to typical OA, but it progresses much more quickly. Sometimes, there is a known underlying cause, such as an infection or injury. In other cases, doctors cannot identify the cause.

Treatment may include medications to manage pain or joint replacement surgery. People with worsening joint pain should contact a doctor for an expert opinion.