Overview
Osteoarthritis (OA) of multiple joints is a chronic, degenerative joint disease characterized by cartilage breakdown, bone remodeling, and joint inflammation, leading to pain, stiffness, and functional impairment 5.Diagnosis
Clinical history and physical examination essential for identifying joint pain, stiffness, and reduced range of motion 5.
Radiographic imaging (X-rays) to assess joint space narrowing, osteophyte formation, and subchondral bone changes 5.
No specific laboratory tests; inflammatory markers may be normal 5.Management
First-line treatments:
- Weight management and physical therapy to improve joint function and reduce pain 5.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief (dose varies by patient need) 5.
Adjunctive treatments:
- Intra-articular corticosteroid injections for localized pain relief 5.
- Hyaluronic acid injections may provide short-term symptomatic relief 5.Special Populations
Elderly: Emphasis on conservative management with physical therapy and assistive devices; caution with polypharmacy 5.
Comorbidities: Tailor NSAID use considering cardiovascular and gastrointestinal risks; monitor for drug interactions 34.Key Recommendations
Implement multimodal pain management including physical therapy and weight control to improve function and reduce pain (Evidence: Moderate) 5.
Consider intra-articular corticosteroid injections for patients with refractory joint pain, guided by clinical response (Evidence: Moderate) 5.
Use NSAIDs cautiously in elderly patients due to increased risk of adverse effects; consider alternatives like topical NSAIDs when appropriate (Evidence: Moderate) 35.References
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3 Cruciol-Souza JM, Thomson JC. A pharmacoepidemiologic study of drug interactions in a Brazilian teaching hospital. Clinics (Sao Paulo, Brazil) 2006. link
4 Maggini M, Menniti Ippolito F, Spila Alegiani S, Traversa G, Fortini M. Drug utilization studies within the VIDEOFAR project. Annali dell'Istituto superiore di sanita 1991. link
5 Jackson R. Hutchinson's Archives of Surgery revisited. Archives of dermatology 1977. link