Presentation
At the time of presentation, the patient already underwent 6 joint replacement surgeries. Family history was unremarkable. [ncbi.nlm.nih.gov]
In the knee, sharpening of the tibial spines and the more typical marginal osteophytes may be present (see the image below). [emedicine.com]
Entire Body System
- Pain
Pain-relieving creams applied to the skin over the joints can provide relief of minor arthritis pain. [medicinenet.com]
In the rat model for osteoarthritis pain, researchers found: an increase in CB2 receptors in neurons and microglia (essential supportive cells for neurons) markers of central sensitization (i.e. a heightened response to pain as a result of pain neuron [medicaljane.com]
PHASE I - Pain Relief & Protection Managing your hip pain. Hip pain is the main reason that you seek treatment for hip arthritis. Regular application of ice packs is highly recommended to reduce your hip pain. [physioworks.com.au]
Medications Osteoarthritis leads to pain and stiffness in the joints. Medication cannot reverse damage, but it can help reduce pain. Acetaminophen (paracetamol, Tylenol) : These can relieve pain in patients with mild to moderate symptoms. [medicalnewstoday.com]
Humid and cold weather increases the pain in many patients. Acetaminophen is often recommended because it relieves pain with the fewest side of effects. [disabled-world.com]
- Falling
People with OA have risk factors such as decreased function, muscle weakness and impaired balance that make them more likely to fall. Side effects from medications used for pain relief can also contribute to falls. [physio-pedia.com]
Risk of Falls and Fall Injuries Adults with arthritis were about 2.5 times more likely to have two or more falls and suffer a fall injury in the past 12 months compared with adults without arthritis. 4 Top of Page References Barbour KE, Helmick CG, Theis [web.archive.org]
Falls People with osteoarthritis experience as much as 30 percent more falls and have a 20 percent greater risk of facture than those without OA. Having OA can decrease function, weaken muscles and make it more likely that someone has a fall. [arthritis.org]
- Fatigue
The central activation ratio ( P < .001, Cohen d = -1.74) and fatigue index ( P = .003, Cohen d = -0.95) were lower among patients only early after ACLR. [ncbi.nlm.nih.gov]
But those with arthritis commonly discover that if they don’t exercise regularly, they’ll pay the price in pain, stiffness, and fatigue. [health.harvard.edu]
It can be stimulated by cold, trauma and fatigue. This pain occurs at the level of the subchondral bone and in capsuloligamentar and muscular structures. [physio-pedia.com]
Common symptoms include morning pain and stiffness for more than an hour, fatigue, occasional fever, feelings of malaise, and inflammation of the joints in the wrists and fingers, as well as the neck, shoulders, elbows, hips, knees, ankles, and feet, [newsmax.com]
- Congestive Heart Failure
insufficiency, arrest (adult) 1,156 1.9 47 9 Other complications of pregnancy 1,062 1.8 271 10 Previous C-section 1,054 1.8 218 11 Acute cerebrovascular disease 1,043 1.7 45 12 Diabetes mellitus with complications 964 1.6 109 13 Congestive heart failure [hcup-us.ahrq.gov]
heart failure or those taking diuretics or ACE-inhibitors). [pamf.org]
- Walking with a Cane
Some examples include: Cushioning shoe inserts can ease the pressure put on the hip joint when walking. Using a cane can provide extra stability. [arthritis-health.com]
A cane takes weight off your knee or hip as you walk. Hold the cane in the hand opposite the leg that hurts. Gripping and grabbing tools may make it easier to work in the kitchen if you have osteoarthritis in your fingers. [mayoclinic.org]
Walking sticks or canes can be useful in reducing the pressure on your ankle, knee, and hip joints while walking. A walking stick can also improve your confidence to walk if you feel less stable walking. [oarsi.org]
Gastrointestinal
- Dyspepsia
[…] receiving APAP. 11 For individual GI AEs, significantly more patients in the diclofenac and misoprostol group experienced abdominal pain and abnormal serum glutamic oxaloacetic transaminase levels compared with those given APAP. 11 The incidence of dyspepsia [web.archive.org]
Meta-analysis of dyspepsia and nonsteroidal antiinflammatory drugs. Arthritis Rheum. 2003;49(4):508–18. PubMed CrossRef Google Scholar 71. Watson D, Yu C, Bolognese J, et al. [doi.org]
1.24 [0.73, 2.12] 15.3 Other 2 750 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.49, 1.61] 16 Adverse Effects Show forest plot 5 Risk Ratio (M‐H, Random, 95% CI) Subtotals only 16.1 Diarrhea 5 1242 Risk Ratio (M‐H, Random, 95% CI) 3.81 [2.54, 5.71] 16.2 Dyspepsia [dx.doi.org]
Cardiovascular
- Hypertension
The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance) of osteoarthritis patients regardless of hypertensive condition. [ncbi.nlm.nih.gov]
[…] sub group: Hypertension: 25mg 12 weeks 1 2714 Risk Ratio (M‐H, Fixed, 95% CI) 1.13 [0.75, 1.70] 1.18 Pre study hypertensive sub group: Lower extremity oedema 25mg 12 weeks 1 2714 Risk Ratio (M‐H, Fixed, 95% CI) 0.96 [0.68, 1.37] 1.19 Pre‐study hypertensive [doi.org]
In addition, it is linked to other co-morbidity problems such as hypertension or cardiovascular diseases, among others. The symptoms of osteoarthritis are progressive and dilated over time. [oafifoundation.com]
- Heart Failure
insufficiency, arrest (adult) 1,156 1.9 47 9 Other complications of pregnancy 1,062 1.8 271 10 Previous C-section 1,054 1.8 218 11 Acute cerebrovascular disease 1,043 1.7 45 12 Diabetes mellitus with complications 964 1.6 109 13 Congestive heart failure [hcup-us.ahrq.gov]
failure or those taking diuretics or ACE-inhibitors). [pamf.org]
Skin
- Erythema
Marked warmth and erythema in a joint suggests a crystalline etiology. Arthrocentesis (aspiration of the joint) helps aid in distinguishing between these types of arthritis if the diagnosis is not clear by history, physical exam, and radiographs. [physio-pedia.com]
Incisional erythema developed in one patient, who was given antibiotics. In a second patient, calf swelling developed in the leg that had undergone surgery; venography was negative for thrombosis. [content.nejm.org]
Only one patient reported an erythema as side effect. Implications for research Further large scaled studies are recommended with special attention to the findings in this meta‐analysis to the therapeutic LLLT application. [doi.org]
Musculoskeletal
- Arthritis
Miller, S.Armfield What is Hip Arthritis? Hip Arthritis Hip arthritis commonly describes the most common for of hip arthritis, which is known medically as hip osteoarthritis. [physioworks.com.au]
Rheumatoid arthritis often affects areas on both sides of the body. [newsmax.com]
Osteoarthritis is also known as degenerative arthritis, reflecting its nature to develop as part of the aging process. As the most common form of arthritis, osteoarthritis affects millions of Americans. [foothealthfacts.org]
Prolonged stiffness (greater than one hour) points more to an inflammatory arthritis eg rheumatoid arthritis. Marked warmth and erythema in a joint suggests a crystalline etiology. [physio-pedia.com]
- Knee Pain
[…] covariates, including bilateral knee pain and ambulatory physical activity. [ncbi.nlm.nih.gov]
The aim of this study was to evaluate the temporal effects of acupuncture on chronic knee pain due to knee osteoarthritis by means of a meta-analysis. [doi.org]
Among Americans 55 years and older, 40 percent have frequent knee pain or knee osteoarthritis. In the elderly, knee OA is responsible for as much chronic disability as cardiovascular disease. [northwestern.edu]
- Osteophyte
Objectives: To identify molecular differences between chondrocytes from osteophytic and articular cartilage tissue from OA patients. [ncbi.nlm.nih.gov]
Growth of osteophytes is one of the best indicators of disease progression. Fractured osteophytes result in intra-articular loose bodies. [emedicine.com]
The stationary phase of disease progression in osteoarthritis involves the formation of osteophytes and joint space narrowing. Osteoarthritis progresses further with obliteration of the joint space. [emedicinehealth.com]
- Joint Stiffness
The absolute reduction in finger joint stiffness for the exercise group, compared with the control group, was 7% (3% to 10%). [ncbi.nlm.nih.gov]
Finger joint stiffness Four studies assessed participant‐reported finger joint stiffness and provided post‐treatment/short‐term data on 368 participants ( Figure 6 Analysis 1.4 ). [doi.org]
Other symptoms may include: Swelling or tenderness in one or more joints, especially before or during a change in the weather Loss of flexibility of a joint Stiffness after getting out of bed A crunching feeling or sound of bone rubbing on bone Bony lumps [spineuniverse.com]
Joint Stiffness Morning stiffness is common with osteoarthritis and typically lasts 30 minutes or less (less than is characteristic of rheumatoid arthritis). [verywellhealth.com]
- Joint Swelling
Patients were classified as having clinical OA if on examination there was hard tissue enlargement involving at least 2 of 10 selected joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue enlargement of at least 2 distal interphalangeal [ncbi.nlm.nih.gov]
Symptoms People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following: Pain and stiffness in the joint Swelling in or near the joint Difficulty walking or bending the joint Some patients with osteoarthritis [foothealthfacts.org]
In contrast, a joint with osteoarthritis will have, to varying degrees: Damage to the joint’s cartilage as it becomes less elastic and more brittle Bony spurs growing around the edge of the joint Swelling of the joint due to inflammation Inadequate lubricating [oarsi.org]
Urogenital
- Kidney Failure
Some people with asthma, high blood pressure, kidney failure and heart failure may not be able to take anti-inflammatory painkillers. Read the leaflet that comes with the medicine for a list of other possible side-effects. [patient.info]
Neurologic
- Sciatica
(This recommendation contrasts with the recommendation that people with low back pain and sciatica put a pillow between their knees. For such people, using a pillow relieves the stress on the lower back and hip [see Sciatica].) [msdmanuals.com]
Muscle-related Pain Piriformis Syndrome Muscle Pain - Muscle Strain Poor Hip Core DOMS - Delayed Onset Muscle Soreness Cramps Core Stability Deficiency Systemic Diseases Rheumatoid Arthritis Fibromyalgia Osteoporosis Referred Sources Sacroiliac Joint Pain - SIJ Sciatica [physioworks.com.au]
View Article PubMed Google Scholar Dahm KT, Bruberg KG, Jamtvedt G, Hagen KB: Advice to rest in bed versus advice to stay active for acute low back pain and sciatica. Cochrane Database Syst Rev. 2010, 6: CD007612. [doi.org]
Workup
An 81-year-old woman with bilateral severe knee OA was initially seen and evaluated in an outpatient physiatry clinic after multiple previous workups of her ongoing knee pain. [ncbi.nlm.nih.gov]
At the University of Michigan Department of Rheumatology, we do a full workup to determine what kind of arthritis you have in order to determine an effective treatment plan. [uofmhealth.org]
The primary provider will be able to evaluate to see if further workup is needed. A diagnosis usually can be made based on specific symptoms, a thorough physical examination and x-ray results. [aans.org]
See Workup for more detail. [emedicine.com]
X-Ray
- Joint Space Narrowing
In major weight-bearing joints, a greater loss of joint space occurs at those areas subjected to the greatest pressures; this effect is in contrast to that of inflammatory arthritides, in which uniform joint-space narrowing is the rule. [emedicine.com]
[…] outcomes, joint space narrowing in index and in contralateral knee. [doi.org]
Key radiographic features are joint space narrowing, sclerosis, and osteophytosis. If all three of these findings are not present, another diagnosis should be considered. [radiopaedia.org]
We report one such case in a 30-year-old woman with synovial osteochondromatosis of the hip and progressive osteoarthritis caused by femoroacetabular impingement with joint-space narrowing. [ncbi.nlm.nih.gov]
Treatment
The aim of this study was to compare the function scores of different surgeries in the treatment of knee osteoarthritis (KOA). [ncbi.nlm.nih.gov]
A rheumatologist can detect arthritis and prescribe the proper treatment. The goal of treatment in OA is to reduce pain and improve function. Exercise is an important part of OA treatment, because it can decrease joint pain and improve function. [rheumatology.org]
Prognosis
Additionally, with the complicating role of surgical intervention in prognosis, “prognosis” will be difficult to investigate in the future. [doi.org]
For example, the prognosis for hip osteoarthritis may be different than the prognosis for hand osteoarthritis. [emedicinehealth.com]
Etiology
This article introduces a novel imaging technique of 4D CT that aims to identify kinematic features that may be associated with the etiology of TMJ-OA. [ncbi.nlm.nih.gov]
In cases were it is not consider: Periarticular structure derrangement: Periarticular pain that is not reproduced by passive motion or palpation of the joint should suggest an alternate etiology such as bursitis, tendonitis or periostitis. [physio-pedia.com]
Epidemiology
Methods Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. [doi.org]
[…] of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, PR, Brazil. [ncbi.nlm.nih.gov]
[…] and Epidemiology, Erasmus MC, Rotterdam, the Netherlands. 10 deCODE genetics/Amgen, Reykjavik, Iceland. 11 Department of Orthopaedic Surgery, Akureyri Hospital, Akureyri, Iceland. 12 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 13 [worldcat.org]
Pathophysiology
Our understanding of the pathophysiology of hip osteoarthritis (OA) has improved significantly in the last decade. [doi.org]
CONCLUSIONS: Plain radiographs and MRI examinations performed during follow-up suggested that the pathophysiology of the patient's knee OA and joint pain may have been primarily due to bone alterations. [ncbi.nlm.nih.gov]
One important component of osteoarthritis pathophysiology is subchondral bone sclerosis. [dx.doi.org]
Prevention
This long-term use results in destruction of hyaline cartilage, a firm connective tissue found in joints that prevents bones from rubbing against each other and getting damaged. [medicaljane.com]
To emphasize disease modification and prevention, we describe a multi-disciplinary systems-based approach encompassing biology, mechanics, and structure to define pre-osteoarthritic disease processes. [ncbi.nlm.nih.gov]
Is OA Preventable? Yes, and since there's no cure for OA, prevention is your best bet. You can lower your risk by staying physically active, maintaining a healthy weight, and preventing injuries to your joints. [prevention.com]