Last reviewed: June 2020
Last updated: May  2020

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

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

Risk factors

  • age >50 years
  • female sex
  • obesity
  • genetic factors
  • knee malalignment
  • physically demanding occupation/sport
  • high bone mineral density

Diagnostic investigations

1st investigations to order

  • x-ray of affected joints
  • serum CRP
  • serum erythrocyte sedimentation rate (ESR)
More 1st investigations to order

Investigations to consider

  • rheumatoid factor (RF)
  • anti-cyclic citrullinated peptide (anti-CCP) antibody
  • MRI of affected joints
More investigations to consider

Treatment algorithm

Contributors

Fadi Badlissi

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

MA

Disclosures

FB has received an honorarium as an advisory board member for Fidia Pharmaceuticals.

Peer reviewersVIEW ALL

Assistant Professor of Medicine

Boston University Clinical Epidemiology Research and Training Unit

Boston University School of Medicine

Boston

MA

Disclosures

DH declares that he has no competing interests.

Professor of Clinical Rheumatology

Department of Rheumatology

King’s College

London

UK

Disclosures

Not disclosed.

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