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Last reviewed: 16 Mar 2025
Last updated: 20 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • pain
  • functional difficulties
  • knee, hip, hand, or spine involvement
  • bony deformities
  • limited range of motion
  • malalignment

Other diagnostic factors

  • tenderness
  • crepitus
  • stiffness
  • shoulder, elbow, wrist, or ankle involvement
  • effusion
  • antalgic gait

Risk factors

  • age >50 years
  • female sex
  • obesity
  • genetic factors
  • joint anatomy and/or malalignment
  • physically demanding occupation/sport
  • post trauma/injury
  • high bone mineral density

Diagnostic investigations

1st investigations to order

  • history and physical examination

Investigations to consider

  • x-ray of affected joints
  • serum CRP
  • serum erythrocyte sedimentation rate (ESR)
  • rheumatoid factor (RF)
  • anti-cyclic citrullinated peptide (anti-CCP) antibody
  • MRI of affected joints
  • ultrasound scan
  • CT

Treatment algorithm

Contributors

Authors

Fadi Badlissi, MD, MSc
Fadi Badlissi

Assistant Professor

Harvard Medical School

Attending Physician

Director of the Musculoskeletal Medicine Unit

Department of Orthopedics & Division of Rheumatology

Beth Israel Deaconess Medical Center

Boston

MA

Disclosures

FB has received reimbursement from ANI Pharmaceutical for attending an advisory board meeting.

Peer reviewers

Amanda E. Nelson, MD, MSCR, RhMSUS

Associate Professor

University of North Carolina at Chapel Hill

NC

Disclosures

AN serves on the OARSI Board of Directors, is an Associate Editor of Osteoarthritis and Cartilage, is medical advisor to the Osteoarthritis Action Alliance, and has received grant funding from NIH/NIAMS and the CDC.

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