Osteoarthritis

Last reviewed: 29 Apr 2022
Last updated: 30 Nov 2021

Summary

Definition

History and exam

Key diagnostic factors

  • pain
  • functional difficulties
  • knee, hip, hand, or spine involvement
  • bony deformities
  • limited range of motion
  • malalignment
More key diagnostic factors

Other diagnostic factors

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

Risk factors

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

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)
  • anticyclic citrullinated peptide (anti-CCP) antibody
  • MRI of affected joints
  • ultrasound scan
  • CT
More investigations to consider

Treatment algorithm

ACUTE

joint pain: medical management

ONGOING

persistent pain despite multiple treatment modalities or with severe disability

Contributors

Authors

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

Disclosures

FB declares that he has no competing interests.

Peer reviewers

David Hunter, MD

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.

David L. Scott, MD, FRCP

Professor of Clinical Rheumatology

Department of Rheumatology

King’s College

London

UK

Disclosures

Not disclosed.

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