Osteoarthritis is the most common form of arthritis and a leading cause of disability. It is a degenerative joint disease affecting cartilage and bone within a joint. Risk factors include age, obesity, joint injury, genetics, and mechanical stress on joints. The disease progresses as mechanical stress damages cartilage over time via pathways that increase matrix metalloproteinases and cytokines like IL-1β and PGE2 produced by chondrocytes and synovium. This leads to loss of cartilage and changes in bone. Osteoarthritis typically causes joint pain that worsens with use and improves with rest. It can be diagnosed in those over 45 years old based on symptoms and signs like limited range of motion and joint enlargement

1. OSTEOARTHRITIS
PRESENTER: Dr. Ferdinand Mynthlu
MODERATOR: Prof. N. Santa

2. OUTLINE
INTRODUCTION
DEFINITION AND CLASSIFICATION
RISK FACTORS
PATHOGENESIS
CLINICAL FEATURES AND DISTRIBUTION
INVESTIGATIONS
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT

3. INTRODUCTION
Osteoarthritis (OA) is the most common form of arthritis in the world.
Presents with joint pain +/- loss of function
Can present as asymptomatic incidental finding or a permanently disabling disorder.
Affects about 3.3 to 3.6% globally and causes moderate to severe disability in 43
million people, making it the 11th most debilitating disease worldwide.
It is the most frequent joint disease with a prevalence of 22% to 39% (28%) in India.

4. DEFINITION & CLASSIFICATION
Osteoarthritis (OA) is a chronic degenerative disorder of multifactorial etiology
characterized by the loss of articular cartilage, hypertrophy of bone at the margins,
subchondral sclerosis, and range of biochemical and morphological alterations of the
synovial membrane and joint capsule.
May be primary or secondary
Primary OA is more common and is diagnosed in the absence of a predisposing
trauma or disease but is associated with the risk factors
Secondary OA occurs with a pre-existing joint abnormality.

6. RISK FACTORS

12. PATHOGENESIS
There are numerous pathways that lead to joint failure
The pathologic sine qua non of disease is hyaline articular cartilage loss.
Mechanical stress to the joint alters the metabolism of chondrocytes, leading to
increase Matrix metalloproteinases (MMPs), NO, PGE2
MMPs cause damage to chondrocytes and articular cartilage, which cause the
synovium to produce more NO, PGE2 and IL1
IL1 acts on the chondrocytes and leads to production of more MMPs causing
more damage to the articular cartilage

19. CLINICAL FEATURES AND
DISTRIBUTION OF
DISEASE

26. INVESTIGATIONS

30. DIAGNOSIS
OA is a clinical diagnosis and can be diagnosed with
confidence if the following are present:
1) pain worse with activity and better with rest
2) age more than 45 years
3) morning stiffness lasting less than 30 minutes
4) bony joint enlargement
5) limitation in range of motion.

36. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the
Management of Osteoarthritis of the Hand, Hip, and Knee

44. THANK YOU

45. REFERENCES
• Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee
osteoarthritis in India and related factors. Indian J Orthop. 2016 Sep;50(5):518-
522.
• Sen R, Hurley JA. Osteoarthritis. [Updated 2022 May 1]. In: StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing; 2022
• Harrison’s internal medicine 20th edition.
• Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J 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):149-162.