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Osteoarthritis

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  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 19 Sep 2025
最后更新： 20 Nov 2024

小结

定义

病史和体格检查

关键诊断因素

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

其他诊断因素

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

危险因素

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

诊断性检查

首要检查

  • history and physical examination
完整详情

需考虑的检查

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

治疗流程

急症处理

joint pain: medical management

持续性治疗

persistent pain despite multiple treatment modalities or with severe disability

撰稿人

作者

Fadi Badlissi, MD, MSc
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

利益声明

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

同行评议者

Amanda E. Nelson, MD, MSCR, RhMSUS

Associate Professor

University of North Carolina at Chapel Hill

NC

利益声明

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.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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.全文  摘要

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

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.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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