Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- dolor
- dificultades funcionales
- afectación de la rodilla, cadera, mano o columna
- deformidades óseas
- rango de movimiento limitado
- alineación incorrecta
Other diagnostic factors
- sensibilidad a la palpación
- crepitación
- rigidez
- afectación de hombro, codo, muñeca o tobillo
- derrame
- marcha antálgica
Risk factors
- >50 años de edad
- sexo femenino
- obesidad
- factores genéticos
- anatomía y/o mala alineación de la articulación
- ocupación/deporte físicamente exigente
- después de un traumatismo/lesión
- alta densidad mineral ósea
Diagnostic tests
1st tests to order
- anamnesis y exploración física
Tests to consider
- radiografía de las articulaciones afectadas
- proteína C-reactiva sérica
- velocidad de sedimentación globular (VSG) sérica
- factor reumatoide (FR)
- anticuerpo antipéptido cíclico citrulinado (anti-CCP)
- resonancia magnética (IRM) de las articulaciones afectadas
- ultrasonido
- tomografía computarizada (TC)
Treatment algorithm
dolor de articulación: manejo médico
dolor persistente a pesar de múltiples modalidades de tratamiento o con discapacidad grave
Contributors
Authors
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
MA
Disclosures
FB has received reimbursement from ANI Pharmaceutical for attending an advisory board meeting.
Peer reviewers
Amanda E. Nelson, MD, MSCR, RhMSUS
Associate Professor
University of North Carolina at Chapel Hill
NC
Disclosures
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.
References
Key articles
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.Full text Abstract
National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. Oct 2022 [internet publication].Full text
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.Full text Abstract
Reference articles
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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