In the elderly with cognitive impairment, the evaluation and Distance Healing Sessions focus on behavioral changes and non-verbal cues, vocalizations and facial expressions. OA is classified as primary (with no history of trauma, either localized or generalized), and secondary (induced by some triggering factor), which in turn is divided into dysplastic, post-traumatic, post-inflammatory, endocrine-metabolic and of unknown etiology. The diagnosis of OA is essentially clinical and is confirmed with imaging studies (radiology, tomography, ultrasonography, magnetic resonance), analysis of synovial fluid and arthroscopy.
The pathogenesis of OA is complex and not of the all elucidated, since the disease develops in two conditions: before structural properties of the cart normal subchondral bone and bone but excessive joint loads, or a reasonable load, but a deficient cartilaginous or bone structure. OA is characterized by a disorder of the balance between degradation and synthesis of the cartilaginous matrix.
