Common causes of joint pain include conditions like osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, and injuries. Osteoarthritis is the most common cause, affecting 40% of people with joint pain. It is a degenerative joint disease involving the breakdown of cartilage. Rheumatoid arthritis is an inflammatory condition affecting multiple joints and tissues. Diagnosis involves considering history, symptoms, examination and sometimes investigations. Treatment options depend on the underlying cause but may include medications, physiotherapy, exercise, weight loss, or in some cases surgery.

1. Common Causes of Joint Pain

2. Painful joint are
extremely common
condition.

3. Most of patient
want an immediate
and permanent
relief of their pain.

4. Others
10%RA and
AS
10%
N.A.R.
40%
O.A.
40%
Common causes of joint pain

5. Extra-articular causes of joint pain
• Bursitis.
• Tendinitis.

6. Extra-articular causes of joint pain
• Bursitis.
–Prepatellar bursitis.
–Supra patellar bursitis.
• Tendinitis.
–Common extensor tendinitis Tennis Elbow.
–Achelis tendinitis.
–Planter fasitis.

7. Intra-articular causes of joint Pain
 Degenerative Osteoarthritis
 Inflammatory RA
 Infective Septic arthritis
 Trauma Fracture
Dislocation
Soft tissue injury
 DI IT

8. Diagnosis
• History
• Examination
• Relevant investigation

9. History
• Onset of pain
• Duration of pain
• Aggravating factor
• Relieving factor
• Associated symptom

10. Osteoarthritis
• Onset of pain
• Duration of pain
• Aggravating factor
• Relieving factor
• Associated symptom

11. Osteoarthritis
• Onset of pain Gradual
• Duration of pain Long
• Aggravating factor Activity
• Relieving factor Rest
• Associated symptom Joint swelling

12. Rheumatoid Arthritis
• Onset of pain
• Duration of pain
• Aggravating factor
• Relieving factor
• Associated symptom

13. Rheumatoid Arthritis
• Onset of pain Gradual
• Duration of pain Long
• Aggravating factor Rest
• Relieving factor Activity
• Associated symptom Morning
Stiffness
weakness
weight loss

14. Septic Arthritis
• Onset of pain
• Duration of pain
• Aggravating factor
• Relieving factor
• Associated symptom

15. Septic Arthritis
• Onset of pain Gradual
• Duration of pain Short
• Aggravating factor Activity
• Relieving factor Rest Analgesia
• Associated symptom Fever

16. Trauma
• Onset of pain
• Duration of pain
• Aggravating factor
• Relieving factor
• Associated symptom

17. Trauma
• Onset of pain Sudden
• Duration of pain Short
• Aggravating factor Movement
• Relieving factor Rest and
analgesia
• Associated symptom H/o trauma

18. Rheumatoid Arthritis
A systemic inflammatory condition that:
• Affects multiple joints as well as various body
systems.
– Swollen joints
– Morning stiffness

19. What is Osteoarthritis ?

20. Osteoarthritis is a wear and
tear disease of joints.
Osteoarthritis has also been
termed as Degenerative joint
Disease

21. What happens in Osteoarthritis
Deterioration of healthy cartilage

23. What are early symptom of
Osteoarthritis

24. What are early symptom of
Osteoarthritis
•Aches and stiffness in joints.
•Difficulty on climbing stairs and
squatting.
•Pain on activity and relief of pain on
rest.

25. • Age is an important risk factor
• Female sex,
• Obesity
• Family history
• Major joint trauma, repetitive stress
Who is at risk of developing
Osteoarthritis

26. Cartilage
•Is a watery rubbery substance which acts
like a cushion in between the joint
•Is made up of 65% of water.
•Cartilage cell Chondrocytes.
•Ground substance Matrix

27. Collagen
•Gives cartilage
its shock
absorption
property.
Proteoglycans
•Give cartilage its
ability to stretch and
than bounce back
elasticity.
Cartilage Matrix
As with all things the
collagen & proteoglycan
grow old

28. •X-rays do not show cartilage.
•In a normal joint a gap is seen
between the bones.
•In Osteoarthritis this gap between
the bones gradually diminishes and
disappears.
What will X-rays show ?

29. Normal Knee Joint

30. Early medial joint space narrowing

31. Early knee Osteoarthritis

32. Severe Knee Osteoarthritis

33. Severe Knee OA with Deformity

34. Early knees varus deformity

35. Severe knees varus deformity

36. • Non-operative
• Operative-treatment
What are the treatment options?

37. –Weight reduction
–Physiotherapy and exercise
–Symptomatic medical treatment
–Disease modifying medical treatment
–Local application gel
–Intra-articular injection
Non-operative treatment options?

41. According to The Lancet [a well known medical
journal]
Ref: The Lancet Vol 573 Jan 27 2001
Treatment of OA can be classified into
1. Symptom modifying agents eg NSAID,
Simple analgesic, Opioids eg Tramadol.
2. Disease modifying agents eg Glucosamine
sulphate