2. DEFINITION
Osteoarthritis is a long term chronic disease characterised by the deterioration
of cartilage in joints which results in bones rubbing together and creating
stiffness, pain and impaired movement
3. EPIDEMIOLOGY
In the world 9.6% of men and 18% of women of age greater than 60 years
have symptomatic Osteoarthritis
In India, prevalence of Osteoarthritis is 22%-39%
4. TYPES
Primary Osteoarthritis
Also called as idiopathic OA
Cause of this type is unknown
Secondary Osteoarthritis
It is occurs due to specific cause like:
Rheumatoid Arthritis
Other type of arthritis
Trauma
Metabolic and endocrine disorders
Congenital factors
5.
6. RISK FACTORS
Age- Increasing the age increases risk of Osteoarthritis
Gender-Women are greater risk of getting Osteoarthritis
than men
Obesity
Traumatic injury
Persons with family history of OA
Persons working in:
Construction sites
Health care settings
Factories
Carpentry works
Farming
Sports persons like:
Wrestlers
Boxers
Cyclers
Football and base ball players
10. CLINICAL PRESENTATION
Pain
Tenderness
Crepitus
In joints of hands, knee, hip, spine and feet
Limited motion with passive or active movement
Deformities like:
Herberden’s nodes (at distal interphalangeal joints)
Bouchard’s nodes ( at proximal interphalangeal joints)
Bow legs
Loss of reflexes if spine is affected
Parasthesia
13. DIAGNOSIS
Medical history of other arthritic problems
Physical examination
Radiograph findings
Lab tests
14. DIAGNOSIS CRITERIA
For hip OA
Pain in the hip
Any 2 of the following:
⚫ ESR<20mm/hour/
⚫ Femoral / Acetabular
⚫ Osteophytes on radiography/
⚫ Joint space narrowing
For Knee OA
Pain in the knee
Osteophytes on radiography
Any 1 of the following:
⚫ Age greater than 50 years
⚫ Morning stiffness not more than 30
minutes
⚫ Crepitus on motion
⚫ Bony enlargement
⚫ Bony tenderness
⚫ Palpable warmth
15. NON PHARMACOLOGICAL TREATMENT
Exercise
Weight loss
Patient education
Use of assistive devices
Use of shoe insoles
Application of heat
Use of fitted knee braces
Lateral patellar taping
Surgeries like:
Arthroplasty
Osteotomy
Arthrodesis
Joint replacement
Total knee arthroplasty
16. TREATMENT ALGORITHM
Knee and hip osteoarthritis
First line agents include:
Acetamiophen
Topical NSAIDs
Oral NSAIDs
Tramadol
Intraarticular corticosteroids
IF ABOVE DRUG FAILS
Second line agents (if above treatment fails or contraindicated) include:
Opiod analgesics
Surgery
Duloxetine
Intraarticular hyaluronates
17. Hand Osteoarthritis
Topical NSAIDs
Oral NSAIDs
Topical Capsaicin
Tramadol
If above single drug treatment fails, use combination if
above drugs