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Osteoarthritis

Patrick Wakefield Joyner, MD, MS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Progressive loss of articular cartilage with reactive changes at joint margins and in subchondral bone

  • Primary osteoarthritis (OA)

    • Idiopathic: categorized by clinical features (local...

DIAGNOSIS

HISTORY

  • Distinguish OA from other types of arthritis by:

    • Absence of systemic findings

    • Minimal articular inflammation

    • Distribution of involved joints (e.g., distal and proximal interphalangeal ...

TREATMENT

GENERAL MEASURES

  • Weight management

  • Heat (in the morning and prior to activity) or cold (in the afternoon or after activity) for symptomatic relief

  • Physical therapy to maintain or regain joint m...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Regularly assess range of motion and functional status.

  • Monitor for GI blood loss, cardiac, renal, and mental status in older patients on NSAIDs ...

REFERENCES

1
Gersing AS, Schwaiger BJ, Nevitt MC, et al. Is weight loss associated with less progression of changes in knee articular cartilage among obese and overweight as assessed with MRI imaging o...

ADDITIONAL READING

  • Chen WL, Hsu WC, Lin YJ, et al. Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a ...

CODES

ICD10

  • M19.90 Unspecified osteoarthritis, unspecified site

  • M19.91 Primary osteoarthritis, unspecified site

  • M19.93 Secondary osteoarthritis, unspecified site

  • M19.92 Post-traumatic osteoarthritis, unsp...

CLINICAL PEARLS

  • Patients with OA typically have morning stiffness lasting for <15 minutes.

  • OA most commonly affects the hips, knees, and hands (PIP and DIP joints).

  • If used, intra-articular steroid i...

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