Inflammation in Osteoarthritis.

Advances in the understanding of chondrocytes and the synovial membrane as targets of and participants in the inflammatory process in articular joints have provided insights into the role of inflammation in cartilage and subchondral bone injury in rheumatic diseases. Reports that describe the inflammatory cellular infiltration of synovial membranes in patients with osteoarthritis, studies that associate cartilage structural injury with synovial membrane inflammatory status, the development of new imaging modalities that quantitatively measure synovial membrane inflammation and basic science advances that explore inflammatory pathways in the synovial cavity all suggest that inflammation plays an important role in cartilage injury in osteoarthritis. As a result there is a shift in the notion that osteoarthritis is a disease caused merely by mechanical forces that increase joint loading. In response to this change in the current paradigm, innovative treatments involving the use of medications that modify the body's immune response (i.e., biologic and disease- modifying agents) are being studied. Implications for the population of Puerto Rico are discussed herein.