Osteoarthritis

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Última revisão: 18 Jun 2025

Última atualização: 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.

Definição

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]

História e exame físico

Principais fatores diagnósticos

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

Detalhes completos

Outros fatores diagnósticos

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

Detalhes completos

Fatores de risco

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

Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

history and physical exam

Detalhes completos

Investigações a serem consideradas

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

Detalhes completos

Algoritmo de tratamento

AGUDA

joint pain: medical management

CONTÍNUA

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

Declarações

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

Revisores

Amanda E. Nelson, MD, MSCR, RhMSUS

Associate Professor

University of North Carolina at Chapel Hill

Declarações

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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 Resumo

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 Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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Diretrizes
- Management of osteoarthritis of the hip
- APA clinical practice guideline for psychological and other nonpharmacological treatment of chronic musculoskeletal pain in adults
Mais Diretrizes
Folhetos informativos para os pacientes
Osteoarthritis: what is it?
Osteoarthritis: what treatments work?
Mais Folhetos informativos para os pacientes
Videos
Hip exam
Knee exam
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Osteoarthritis

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

Outros fatores diagnósticos

Fatores de risco

Investigações diagnósticas

Primeiras investigações a serem solicitadas

Investigações a serem consideradas

Algoritmo de tratamento

joint pain: medical management

persistent pain despite multiple treatment modalities or with severe disability

Colaboradores

Autores

Fadi Badlissi, MD, MSc

Declarações

Revisores

Amanda E. Nelson, MD, MSCR, RhMSUS

Declarações

Referências

Principais artigos

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Diagnósticos diferenciais

Diretrizes

Folhetos informativos para os pacientes

Videos

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