♦  Symptoms: stiffness, pain, joint swelling. Often exacerbated by activity or weight bearing.

♦  Laboratory investigations: Generally not diagnostic, but may be used for differential diagnosis (e.g. crystal deposition for gout or biomarkers for rheumatoid arthritis)

♦  Imaging: Reserve radiographic studies for symptomatic patients. Ultrasound or MRI may be useful in detecting other causes of symptoms, such as meniscal tears.



♦  Lifestyle:  Weight loss, moderate exercise, heating pads or ice packs, supportive devices such as braces or canes. Educate patient that treatment is palliative, not curative.

♦  Medications:  Acetaminophen
                             Non-steroidal anti-inflammatory drugs (NSAIDs)
                             Glucosamine/chondroitin is as effective as NSAIDs in some studies.
                             COX-2 inhibitors, with caution and vigilance about cardiovascular risks
                              Intra-articular corticosteroids provide at least short-term relief in some cases
                              Reserve opioid painkillers for the most severe cases

♦  Surgery:  Joint replacement, for suitable patients in whom other measures provide little relief

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