Osteoarthritis is a common chronic, progressive, degenerative joint disease that affects cartilage and bone within a joint. It most often affects older adults but can also occur in younger people. It is a leading cause of physical disability. Osteoarthritis can be classified as primary, with no known cause, or secondary, due to an underlying condition like injury or obesity. It involves the breakdown and eventual loss of cartilage in one or more joints. Symptoms include pain, stiffness, and reduced mobility. Diagnosis is based on symptoms and confirmed with x-rays showing signs of cartilage loss. Treatment focuses on reducing pain and improving joint function through lifestyle changes, physical therapy, braces, and in some cases surgery.

1. Osteoarthritis
Dr. KV Satish
MD Part-2
Department of PG Repertory

2.  Osteoarthritis (OA) is a common chronic,
progressive, degenerative musculoskeletal
disorder. This is common in the elderly, but
also affects younger people. It’s high
prevalence, especially in elderly and the high
rate of disability related to disease make it a
leading cause of disability in elderly people.

3.  Osteoarthritis is a fourth common leading cause of
disability in the world, and second most common
Rheumatologic problem in India. OA was ranked
equally with heart disease, congestive heart failure
and chronic obstructive pulmonary disease as a cause
of physical disability

4. Classification
 classified mainly into Primary and Secondary OA.
 In Idiopathic or Primary Osteoarthritis the most
common form of the disease, has no predisposing factor
 Secondary Osteoarthritis :attributable to an underlying
cause.

5.  OA for convenience can be categorized into following
types
 Nodal OA: occurs predominantly in middle aged woman
,it affects mainly terminal inter phalangeal and proximal
inter phalangeal joints of the Hands
 Erosive OA: more severe form of nodal OA with
development of destructive sub chondral erosions
particularly affecting PIP joints leading to joints
instability and ankylosis
 Early onset OA: In this typical symptoms and signs of
OA before the age of 45.mostly single joint is effected
with previous history of trauma

6. NODAL OA EROSIVE OA

7.  Involvement of specific joints:
 Knee OA :most commonly affected joint.it may be
unilateral or both joints involved
 Hip OA: in india this is less common than knee OA often
unilaterally present
 Spine OA : cervical and lumbar spine are predominantly
effected. degenarative changes occur both disc and
vertebral bodies

9. Epidemiology
 Osteoarthritis is an important cause of disability and
the second most common musculoskeletal problem
in the world (30%) after back pain (50%)
 The World Health Organization estimates that OA is
a cause of disability in at least 10% of the world
population over age 60 years
 Osteoarthritis is the second most common
rheumatologic problem and it is the most frequent
joint disease with a prevalence of 22% to 39% in
India

10. Etiologic factors
 Age
 Sex
 Joint location
 Obesity
 Joint malalignment
 Hereditary factors
 Repeated use of joints
 Injuries
 Developmental abnormalities
 Menopause

11. PATHOLOGY:
Osteoarthritis is an abnormality of synovial joints
characterized by softening , splitting ,and
fragmentation of articular cartilage not attributable to
direct contact with inflammatory tissue . This is usually
accompanied by subchondral sclerosis and bone cysts
, joints space narrowing and bony overgrowths at
tissue joint margins

12. PATHOLOGICAL CHANGES

13. Clinical features
SIGNS
 Altered gait
 Tenderness
 Hard tissue enlargement
 Swelling with/without
effusion
 Crepitus
 Limitation of motion
 Deformity
 Ligamentous instability
SYMPTOMS
 Pain
 Discomfort
 Depression
 Stiffness
 Reduced function
 Weakness
 Grinding or clicking
 Instability/buckling

14. Diagnosis
 The diagnosis of OA is usually based on clinical and
radiographic features
 There is no Laboratory Investigation For Diagnosis
 R/O other rheumatological conditions

15. ESSENTIALS OF DIAGNOSIS
 A degenerative disorder with minimal articular inflammation
 No systemic symptoms
 Pain relieved by rest; morning stiffness brief
 Radiographic findings:
 Narrowed joint space
 Osteophytes
 Increased density of subchondral bone
 Bony cysts.

16. Kellgren and Lawrenceclassification
 1 – Doubtful(Grade 1): doubtful joint space narrowing (JSN)
and possible osteophytic lipping.
 2 – Minimal(Grade 2): definite osteophytes and possible
JSN.
 3 – Moderate(Grade 3): moderate multiple osteophytes,
definite JSN, some sclerosis, possible bone end deformity.
 4 – SevereGrade 4: large osteophytes, marked JSN, severe
sclerosis definite deformity of bone ends

18. Differential diagnosis
 Rheumatoid arthritis
 Gout
 Psoriatic arthritis
 Haemochromatosis
 Infective arthritis

19. Management
 Patient education
 Exercises
 Reducing weight
 Micronutrients
 Cane/walking aids
 Bracing/orthotics
 Thermotherapy
 Electrotherapies
 Surgical

21. “HOMOEOPATHY-OSTEOARTHRITIS”
Arnica
Ledum pal
Causticum
Rhustox
Bryonia
Ruta
Formica rufa
Calc carb
Calc phos…e.t.c