Osteoarthritis-(OA) is the most common form of arthritis, with up to 40 million people in the US

having been diagnosed with it.

 -Also known as degenerative joint disease
 -generally considered to be noninflammatory.
 -the same cytokines and interleukins seen in inflammatory arthritis are also seen inosteoarthritis,
although in lesser quantity.
 -Theories of etiology include both primary biomechanical, or primary biochemical effects
andsecondary biomechanical-derived effects leading to a gradual loss of articular cartilage.
 -Many patients do not have a clearly identifiable source for their OA
 -Other patients may demonstrate problems such as chronic instability, malalignment, priorinjury,
crystalline disease, past history of meniscectomy, or excessive and repetitive loading
 -A genetic predisposition is present in some patients.
O The knee is the most commonly affected joint.
O Radiographic evidence of OA is common by age 40 years, but clinically significantosteoarthritis is
less common until about age 60 years
 -Typical findings on a radiographic examination reveal loss of articular cartilage shown by
"jointnarrowing" especially on weight-bearing films.
-Osteophytes and subchondral cysts are common radiographic findings.
 -Physical examination reveals pain upon walking (an antalgic gait pattern) or motion of theinvolved
joint.
 -Patients have some degree of limitation of motion, pain and/or crepitus with that motion.
 -Usually there is an effusion in the joint.
 -The initial treatment includes
O activity modification
O weight reduction if indicated
O the use of a cane for lower-extremity problems
O nonsteroidal anti-inflammatory and nonnarcotic analgesic medications if required.
 -Patients should be encouraged to maintain their joint motion and muscular strength.
 -Rarely, an intra-articular corticosteroid injection can be used for an acutely painful joint, but it is
only a temporary solution
 -Surgical options are based on the dramatic success of joint replacement to relieve pain andrestore
function to the arthritic joint.

Synovial Fluid Analysis

 
Clinical Example Normal Noninflammatory(Osteoarthrosis) Inflammatory(Rheumatoid) Septic (Bacterial)
 

 
Color Clear Clear yellow Opalescent yellow Turbid yellow to
green

Viscosity High High Low Low

WBC/mm3 200 200– 2000 200– 100,000 >100,000

% PMM leukocytes <25% <25% >50% >75%

Culture Negative Negative Negative Positive

Mucin clot Firm Firm Friable Friable

Glucose 100% 100% 50–75% <50%

(% of serumglucose)

Total protein Normal Normal Elevated Elevated