12 Jul 2014

Clinical features of osteoarthritis

Most common manifestation of osteoarthritis is joint pain and it is activity related pain occur during activity or immediately after the use of joint and it decreases gradually.
Site of pain - example
1. Hip and knee pain going up and down stairs.
2. Pain in weight bearing joints  while walking.
3. Hand osteoarthritis - pain while cooking.
Nature of pain.
Early in the disease, pain is present only when the affected joint is overused, but later the pain become constant and present even at night. This is associated with stiffness of joint. If early morning stiffness is present, it is very brief usually less than 30 minutes.
Osteoarthritis of knee joint.
In osteoarthritis of knee joint, pain occur on bending the knee. Some people experience buckling, catching and locking of the knee joint. Osteoarthritis of knee joint is the most common cause of chronic knee pain in persons over 45 yrs. In hip osteoarthritis restriction of hip movements will occur.
Investigation in osteoarthritis.
No blood test is required for evaluation of patients with osteoarthritis.
Tests that may be done.
1. Synovial fluid analysis.
2. Xray of joint.
3. MRI test.
Synovial fluid analysis.
If the WBC count more than 1000 it indicate inflammatory arthritis or gout
Correlate poorly with disease activity and joint pain .It may be normal in the early disease.It is indicated if the joint pain does not respond to usual management.
White arrow indicates joint space reduction compared to opposite side
Not a routine part of osteoarthritis evaluation.

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