23. Diagnosis and treatment of arthrosis

Question 1

What is arthrosis?

Answer 1

• AKA osteoarthritis
• The most common joint condition
• Females are affected 3x more than males
• It is usually primary (generalized), but may be secondary to joint disease or other conditions (hemochromatosis, obesity, occupational)
• Usually localized to the knee or hip

Question 2

What is the difference between arthritis and arthrosis?

Answer 2

Question 3

What are the signs and symptoms of arthrosis?

Answer 3

• Heberden’s nodes at DIP:
  
  • Commonly affects DIP joints, thumb CMP joints and the knees
• Bouchard’s nodes at PIP
• Decreases range of movement and mild synovitis

Question 4

What tests can be performed to diagnose or confirm arthrosis?

Answer 4

• Plain radiograph shows L.O.S.S.C.:
  
  • Loss of joint space
  • Osteophytes
  • Subarticular sclerosis
  • Subchondral cysts
  • CRP may be slightly elevated

Question 5

How do we manage arthrosis?

Answer 5

• Core treatment: Exercise
• Analgesia:
  
  • Regular paracetamol +/- topical NSAIDs
    
    • If uneffective, use codeine or short-term oral NSAIDs
• Intra-articular steroid or hyaluronic acid injections
• Surgery:
  
  • Joint replacement (hip or knee)