Osteoarthritis

Diagnosis

Doctors will review the symptoms and do the physical exam to look for certain signs, such as tenderness, swelling, redness and flexibility of the affected joints.

Imaging tests

• X-rays can show the joint space narrowing which indicates cartilage loss. X-rays also reveals bone spurs around the joint and joint deformity or legs deformity.
• Magnetic resonance imaging (MRI) is a diagnostic test that uses radio waves and a powerful magnetic field to create detailed images of bone and soft tissues like cartilage. An MRI can be helpful for complex osteoarthritis but not used in general.

Lab tests

Blood or joint fluid analysis will help confirm the diagnosis.

• Blood tests is not required to diagnose osteoarthritis, but it can be used to rule out other causes of joint pain, such as rheumatoid arthritis.
• Joint fluid analysis is done by inserting a needle to draw fluid from the joint that has been affected to identify whether the pain is triggered by gout or an infection rather than osteoarthritis.

Treatment

Although the diseases cannot be reversed, treatments can relieve pain and help better movement.

Medications

The methods to slow the progression of knee osteoarthritis are

1. Avoid to bend the knee more than 90 degree during sitting.
2. Quadricep muscle exercises.
3. Control or reduce body weight reached to standard BMI

• Acetaminophen. Helps patients who have mild to moderate level of pain from osteoarthritis. But it should not be taken more than the recommended dose as it can cause liver damage.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter drugs, such as ibuprofen and naproxen sodium are composed to relieve pain. NSAIDs that are come in gel type are applied on the skin of the affected joint. The drugs have side effects such as stomach upset, cardiovascular problems, bleeding problems, and can lead to liver and kidney damage.
• Duloxetine. Generally use as an antidepressant. It has shown to treat chronic pain, as well as pain from osteoarthritis.

Therapy

• Physical therapy composes of exercises that will strengthen the joint muscles. It increases flexibility and reduces pain. Regular exercises that are gentle, such as swimming or walking, can be just as effective.
• Occupational therapy designed to find out ways for patients to do carry out their daily tasks without putting additional pressure on the painful joint.
• Transcutaneous electrical nerve stimulation (TENS) uses a low-voltage electrical current for pain relief. It can temporarily relief pain for some patients who have knee and hip osteoarthritis.

Surgical and other procedures

If conservative treatments show no effective results, the following procedures may be considered:

• Cortisone injection is given into the joint, aiming to relieve pain for few weeks. Limitation of injection at three or four times a year due to its side effect of damaging the joints in time.
• Lubrication injection is an injection of hyaluronic acid which is the substance similar to the natural fluid found in the joints. It helps relieving pain by providing cushioning in the knees.
• Realigning bones is carried out when one side of the knee is more damaged by osteoarthritis than the other. The procedure is also known as osteotomy. In a knee osteotomy, the doctor will make an incision across the bone either above or below the knee. Then will remove or add a wedge of bone. This will help putting off the body weight from part of your knee that has been worn-out.
• Joint replacement is a surgical procedure that removes the joint surfaces that are damaged and replaces them with plastic and metal implants. Artificial joints or implants may also wear out or loosen like the natural joints. If that happens, they will have to be replaced again.