Osteoarthritis

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice

Última revisión: 13 Sep 2025

Última actualización: 13 Dec 2024

Osteoarthritis (OA) is a common and frequently debilitating joint disorder; prevalence increases with age.

The most commonly affected joints are the knee, hip, hands, feet, and lumbar and cervical spine.

Presents with joint pain and stiffness that is typically worse with activity.

Radiographs show loss of joint space, subchondral sclerosis, and osteophytes.

Treatments are nonpharmacologic and pharmacologic.

Joint replacement surgery is effective for controlling the pain of OA in advanced disease.

Definición

OA is the result of mechanical and biologic events that destabilize the normal process of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. It involves the entire joint, including the articular cartilage, subchondral bone, pericapsular muscles, capsule, and synovium. The condition leads to loss of cartilage, sclerosis and eburnation of the subchondral bone, osteophytes, and subchondral cysts. It is clinically characterized by joint pain, stiffness, and functional limitation.[1][2]

Anamnesis y examen

Principales factores de diagnóstico

pain
functional difficulties
knee, hip, hand, or spine involvement
bony deformities
limited range of motion
malalignment

Todos los datos

Otros factores de diagnóstico

tenderness
crepitus
stiffness
shoulder, elbow, wrist, or ankle involvement
effusion
antalgic gait

Todos los datos

Factores de riesgo

age >50 years
female sex
obesity
genetic factors
joint anatomy and/or malalignment
physically demanding occupation/sport
post trauma/injury
high bone mineral density

Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

history and physical exam

Todos los datos

Pruebas diagnósticas que deben considerarse

x-ray of affected joints
serum CRP
serum erythrocyte sedimentation rate (ESR)
rheumatoid factor (RF)
anticyclic citrullinated peptide (anti-CCP) antibody
MRI of affected joints
ultrasound scan
CT

Todos los datos

Algoritmo de tratamiento

Agudo

joint pain: medical management

En curso

persistent pain despite multiple treatment modalities or with severe disability

Colaboradores

Autores

Fadi Badlissi, MD, MSc

Assistant Professor

Harvard Medical School

Attending Physician

Director of the Musculoskeletal Medicine Unit

Department of Orthopedics & Division of Rheumatology

Beth Israel Deaconess Medical Center

Boston

Divulgaciones

FB has received reimbursement from ANI Pharmaceutical for attending an advisory board meeting.

Revisores por pares

Amanda E. Nelson, MD, MSCR, RhMSUS

Associate Professor

University of North Carolina at Chapel Hill

Divulgaciones

AN serves on the OARSI Board of Directors, is an Associate Editor of Osteoarthritis and Cartilage, is medical advisor to the Osteoarthritis Action Alliance, and has received grant funding from NIH/NIAMS and the CDC.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2020 Feb;72(2):149-62.Texto completo Resumen

National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. Oct 2022 [internet publication].Texto completo

Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019 Dec;49(3):337-50.Texto completo Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Bursitis
- Gout
- Pseudogout
Más Diferenciales
Guidelines
- Management of osteoarthritis of the hip
- APA clinical practice guideline for psychological and other nonpharmacological treatment of chronic musculoskeletal pain in adults
Más Guidelines
Patient information
Osteoarthritis: what is it?
Osteoarthritis: what are the treatment options?
More Patient information
Videos
Hip exam
Knee exam
More videos
Log in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer

Osteoarthritis

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

Otros factores de diagnóstico

Factores de riesgo

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

Pruebas diagnósticas que deben considerarse

Algoritmo de tratamiento

joint pain: medical management

persistent pain despite multiple treatment modalities or with severe disability

Colaboradores

Autores

Fadi Badlissi, MD, MSc

Divulgaciones

Revisores por pares

Amanda E. Nelson, MD, MSCR, RhMSUS

Divulgaciones

Peer reviewer acknowledgements

Disclosures

Referencias

Artículos principales

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales

Guidelines

Patient information

Videos

Log in or subscribe to access all of BMJ Best Practice

Log in or subscribe to access all of BMJ Best Practice

Log in to access all of BMJ Best Practice