Continuing Medical Education: Understanding Osteoarthritis.

Clinical aspects of osteoarthritis

What joint areas are involved in primary osteoarthritis?

• DIPs
• PIPs
• 1st CMC
• Hips
• Knees
• 1st MTP
• Cervical Spine
• Lumbar Spine

If other areas involved think history of trauma or one of the metabolic causes of OA such as hemachromatosis or CPPD.

What are the clinical characteristics of osteoarthritis?

• Mild morning stiffness (<15 minutes)
• Pain with use
• Swelling (synovial fluid is noninflammatory)
• Gelling (stiffness after rest)
• Boney deformity (Heberden's and Bouchard's nodes)

What are the radiographic feature of osteoarthritis?

• Non-uniform joint space narrowing
• Subchondral sclerosis
• Subchondral cysts
• Osteophytes

What is the basic differential diagnosis for osteoarthritis?

• Rheumatoid arthritis
• Psoriatic arthritis
• Tophaceous urate gout
• Calcium pyrophosphate deposition disease

Surgery for arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

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