Osteoarthritis: Introduction FeedbackA general introduction to Osteoarthritis.Source: Clinical Knowledge Summaries, 01 Apr 2013
Osteoarthritis is defined as a disorder of synovial joints, that is characterized by focal areas of damage to the articular cartilage, remodelling of underlying bone and the formation of osteophytes (new bone at joint margins), and mild synovitis. Knees, hips, and the small joints of the hands are the most commonly affected joints, but any synovial joint can be involved.
The prevalence of osteoarthritis of the knee, hip, and hand increases with age.
It is estimated that osteoarthritis causes joint pain in 8.5 million people in the UK.
The hand is one of the most common sites of pain and osteoarthritic change in older adults.
Osteoarthritis has multiple risk factors but only a few of these are modifiable (e.g. obesity and occupational stress on joints).
The clinical presentation and outcome are extremely variable, both between individuals and at different joint sites. Hand osteoarthritis has a particularly good prognosis and hip osteoarthritis has a poorer prognosis than hand or knee osteoarthritis.
Complications include disability and inability to work.
A working diagnosis of osteoarthritis can be made without radiological or laboratory investigations:
If the person is 45 years of age or more and symptoms and signs clearly suggest osteoarthritis.
If other conditions have been excluded.
Management of osteoarthritis includes:
Assessing the severity of pain and the effect of osteoarthritis on the individual's life.
Formulating a management plan in partnership with the person, taking into account comorbidities; the risk of adverse effects from treatments; and the person's expectations, needs, and anxieties.
The core treatment to be offered to everyone with osteoarthritis is:
Education, advice, assistive devices, and access to information on osteoarthritis.
Strengthening exercise, and aerobic fitness training.
Advice on weight loss, if applicable.
Drug treatment includes regular paracetamol and/or a topical NSAIDs (for knee or hand osteoarthritis). If both are ineffective, oral NSAIDs (standard or coxibs), codeine, topical capsaicin (for hand or knee osteoarthritis), or intra-articular corticosteroids can be considered.
Surgery may be an option for managing osteoarthritis. The most common operations are to replace hip, knee, and base of thumb joints. Less common operations are to replace shoulder, elbow, wrist, metacarpophalangeal, and proximal interphalangeal joints. The ankle joint can be fused or replaced.
The following treatments are not recommended: glucosamine, chondroitin, topical rubifacients, intra-articular hyaluronic acid, acupuncture, and arthroscopic lavage and debridement (unless the person has knee osteoarthritis with a clear history of mechanical locking).
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Osteoarthritis - Medicines Information
- Anadin Ibuprofen (a brand of Ibuprofen)
- Anadin Original (a brand of Aspirin)
- Arthrotec (a brand of Diclofenac Sodium , a brand of Misoprostol)
- Brufen (a brand of Ibuprofen)
- Calprofen (a brand of Ibuprofen)
- Celebrex (a brand of Celecoxib)
- Cuprofen (a brand of Ibuprofen)
- Deltastab (a brand of Prednisolone Acetate)
- Depo-Medrone (a brand of Methylprednisolone Acetate)
- Depo-medrone with Lidocaine (a brand of Lidocaine , a brand of Methylprednisolone Acetate)
- Dexketoprofen trometamol
- Diclofenac potassium
- Diclofenac sodium
- Dicloflex (a brand of Diclofenac Sodium)
- Diclomax (a brand of Diclofenac Sodium)
- Disprin (a brand of Aspirin)
- Eccoxolac (a brand of Etodolac)
- Econac (a brand of Diclofenac Sodium)
- Emflex (a brand of Acemetacin)
- Etoricoxib (a generic version of Arcoxia)
- Feldene (a brand of Piroxicam)
- Froben (a brand of Flurbiprofen)
- Hedex Ibuprofen (a brand of Ibuprofen)
- Hydrocortisone acetate
- Hydrocortistab (a brand of Hydrocortisone Acetate)
- Indolar (a brand of Indometacin)
- Keral (a brand of Dexketoprofen Trometamol)
- Ketocid (a brand of Ketoprofen)
- Ketovail (a brand of Ketoprofen)
- Lidocaine/Methylprednisolone acetate
- Lodine (a brand of Etodolac)
- Methylprednisolone acetate
- Mobiflex (a brand of Tenoxicam)
- Motifene (a brand of Diclofenac Sodium)
- Napratec (a brand of Misoprostol , a brand of Naproxen)
- Naproxen/Esomeprazole magnesium trihydrate
- Nurofen (a brand of Ibuprofen)
- Nu-Seals (a brand of Aspirin)
- Orudis (a brand of Ketoprofen)
- Oruvail (a brand of Ketoprofen)
- Pardelprin (a brand of Indometacin)
- Ponstan (a brand of Mefenamic Acid)
- Powergel (a brand of Ketoprofen)
- Prednisolone acetate
- Relifex (a brand of Nabumetone)
- Seractil (a brand of Dexibuprofen)
- Surgam (a brand of Tiaprofenic Acid)
- Tiaprofenic Acid
- Traxam (a brand of Felbinac)
- Tylex (a brand of Codeine , a brand of Paracetamol)
- Voltarol (a brand of Diclofenac Sodium)
- Voltarol Dispersible (a brand of Diclofenac Sodium)
- Voltarol Emulgel (a brand of Diclofenac Diethylammonium)
- Voltarol Rapid (a brand of Diclofenac Potassium)
- Zacin (a brand of Capsaicin)
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