Thursday, October 22, 2009

Knee Osteoarthritis


67 year old lady with significant right knee pain and reduced mobility.
Her knee x-ray showed medial osteophytes, reduction in medial joint space and sclerosis of medial articular margin. The tibial spines are also sharp. These are signs of moderate osteoarthritis.
Osteoarthritis (OA) of the knee is a chronic, inflammatory, degenerative arthritic condition in which the cartilage in the knee joint gradually wears away. Osteoarthritis affects the knees more than any other joint. The average age at diagnosis of OA of the knee is 50. The incidence of OA increases with age, and is the leading cause of disability among the elderly.
The pain in OA of the knee is a major issue for most patients and is typically related to physical activity such as climbing stairs, getting out of a chair, or jumping. In mild cases, walking may not cause pain since there is minimal bending of the knee involved. The patient may feel stiffness in the knee upon getting up in the morning that usually lasts less than 30 minutes. Many people with severe OA of the knee experience a feeling as if their knee is "giving way" or "buckling under". There also may be swelling of the knee. At rest, pain is usually not present unless OA is severe.
Most of the time, the pain is mechanical and not inflammatory. A major mistake by doctors will be to treat the pain with anti-inflammatory drugs.

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