All of the following statements are true about the pathogenesis of osteoarthritis (OA) EXCEPT:

A. It is simply a “wear and tear” process.

B. Risk factors include aging, joint injury, obesity, and genetics.

C. X-rays may be normal despite significant pain from OA early in the process.

D. Current treatments for OA are directed to controlling pain, and none have been proven to alter the progression of the disease.