Approach to Patient with Osteoarthritis

03/10/2024

Background

Osteoarthritis is the most common type of joint disease, affecting more than 30 million individuals in the United States alone. It is the leading cause of chronic disability in older adults, costing the US greater than $185 billion annually.
Osteoarthritis predominantly involves the weight-bearing joints, including:
- Knees
- Hips
- Cervical and lumbosacral spine
- Feet
Other commonly affected joints include:
- Distal interphalangeal (DIP)
- Proximal interphalangeal (PIP)
- Carpometacarpal (CMC) joints
Traditionally, osteoarthritis was thought to affect primarily the articular cartilage of synovial joints; however, pathophysiologic changes are also known to occur in:
- Synovial fluid
- Underlying (subchondral) bone
- Overlying joint capsule
- Other joint tissues

Risk Factors for Osteoarthritis
Osteoarthritis Signs and Symptoms
- Osteoarthritis of the Hand
- Pain Mechanisms in Osteoarthritis
Osteoarthritis Diagnosis
- Imaging Studies
- Differential Diagnoses
Osteoarthritis Management
- Non-Pharmacologic Interventions
- Pharmacologic Therapy
  - Hand Osteoarthritis
  - Knee Osteoarthritis
  - Hip Osteoarthritis
- Surgical Therapy

Irregular joint space narrowing
Subchondral sclerosis: a dense area of bone (visible on x-ray) just below the cartilage zone of a joint.
Osteophytes (bone spurs): spurs or densifications that develop on the edges of the joint.
Subchondral cyst: a fluid-filled cyst that develops on the surface of a joint

Lateral compartment osteoarthritis of the knee X-ray right knee (AP view) Marked lateral compartment narrowing is accompanied by subchondral sclerosis and osteophyte formation. Tibial spine osteophytes are also visible.
Degenerative disease of spine with osteophyte formation and vacuum disc phenomenon.