Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dor
- dificuldades funcionais
- envolvimento de joelho, quadril, mão ou coluna
- deformidades ósseas
- amplitude de movimentos limitada
- desalinhamento
Other diagnostic factors
- sensibilidade
- crepitação
- rigidez
- complicação no ombro, cotovelo, punho ou tornozelo
- derrame
- marcha antálgica
Risk factors
- idade >50 anos
- sexo feminino
- obesidade
- fatores genéticos
- anatomia e/ou desalinhamento da articulação
- esporte/ocupação com alta demanda física
- após trauma/lesão
- alta densidade mineral óssea
Diagnostic investigations
1st investigations to order
- anamnese e exame físico
Investigations to consider
- raio-X das articulações afetadas
- proteína C-reativa sérica
- velocidade de hemossedimentação (VHS) sérica
- fator reumatoide (FR)
- anticorpo antipeptídeo citrulinado cíclico (anti-CCP)
- ressonância nuclear magnética (RNM) para articulações afetadas
- ultrassonografia
- tomografia computadorizada (TC)
Treatment algorithm
dor nas articulações: tratamento clínico
dor persistente, apesar das várias modalidades de tratamento, ou com incapacidade 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.
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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