Table of Contents
Osteoarthritis is the mechanical degradation of a joint with degeneration of the articular cartilage, periarticular bone remodelling and inflammation.
Risk factors
- Primary osteoarthritis risk factors
- Increasing age
- Obesity
- Family history
- Female gender
- Sports activities
- Secondary osteoarthritis causes
- Pre-existing joint damage: trauma, RA, gout, spondyloarthropathy, septic arthritis, Paget’s disease, avascular necrosis
- Metabolic disease: chondrocalcinosis, haemochromatosis, acromegaly
- Systemic disease: haemophilia (haemarthrosis), neuropathy, haemoglobinopathy
Clinical features
Symptoms
- Joint pain: worse on exercise and relieved by rest, morning pain <30 minutes
- Commonly affected joints: knees, hips, interphalangeal joints of fingers, carpometacarpal joint of thumb
Signs
- Crepitus
- Pain on movement
- Reduced range of movement
- May be bony swellings (osteophytes), joint instability, joint effusions
- Characteristic hand deformities: Heberden’s nodes, Bouchard’s nodes, squaring of carpometacarpal joint of thumb
Investigations
- X-Rays
- Bloods:Â FBC, CRP/ESR
- Only useful for ruling out inflammatory and infectious causes (inflammatory markers not raised in osteoarthritis)
Management
- Conservative: exercise, physiotherapy, weight loss, mobility aids, supportive footwear
- Analgesia: topical NSAID, then oral NSAID if required
- Intra-articular corticosteroid injections
- Joint replacement aims to reduce pain and improve mobility
Reference: NICE ‘NG226 Osteoarthritis in over 16s: diagnosis and management’ 2022
Questions for you
What are the classical features of osteoarthritis on an X-ray?
Oops! This section is restricted to members.
What are the possible complications of joint replacement?
Oops! This section is restricted to members.
What is capsaicin? How does it work? What is a common adverse effect?
Oops! This section is restricted to members.
