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Osteoarthritis

Patrick Wakefield Joyner, MD, MS Reviewed 06/2019
 


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 (localiz...

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 jo...

TREATMENT

GENERAL MEASURES

  • Weight management combined with exercise/physical therapy demonstrates most improvement in patients with OA.

  • Physical therapy to maintain or regain joint motion and muscle str...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Regularly assess range of motion and functional status.

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

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 patients as assessed with MR i...

ADDITIONAL READING

  • Hall M, Castelein B, Wittoek R, et al. Diet-induced weight loss alone or combined with exercise in overweight or obese people with knee osteoarthritis: a systematic review and meta-...

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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