Osteoarthritis

American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the knee[3]Altman R, Asch E, Bloch D, et al; Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29:1039-49. http://www.ncbi.nlm.nih.gov/pubmed/3741515?tool=bestpractice.com

Clinical and laboratory diagnostic criteria:

• Knee pain plus at least 5 of the following 9 criteria: age >50 years; stiffness <30 minutes; crepitus; bony tenderness; bony enlargement; no palpable warmth; erythrocyte sedimentation rate (ESR) <40 mm/hour; rheumatoid factor <1.40; synovial fluid signs of OA.

Clinical and radiographic diagnostic criteria:

• Knee pain plus osteophytes, plus at least 1 of the following 3 criteria: age >50 years; stiffness <30 minutes; crepitus.

American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand[75]Altman R, Alarcon G, Appelrouth D. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990;33:1601-1610. http://www.ncbi.nlm.nih.gov/pubmed/2242058?tool=bestpractice.com

Clinical criteria:

• Hard tissue enlargement involving at least 2 of 10 selected joints, swelling in <3 metacarpophalangeal (MCP) joints, and hard tissue enlargement of at least 2 distal interphalangeal (DIP) joints.

• If the patient has <2 enlarged DIP joints, then deformity of at least 1 of the 10 selected joints is necessary in order to classify the symptoms as being due to OA.

American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip[78]Altman R, Alarcon G, Appelrouth D. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34:505-514. http://www.ncbi.nlm.nih.gov/pubmed/2025304?tool=bestpractice.com

Clinical and laboratory diagnostic criteria:

• Hip pain is present plus either 1) hip internal rotation ≥15°; pain present on internal rotation of the hip; morning stiffness of the hip for ≤60 minutes; age >50 years, or 2) hip internal rotation <15°; ESR ≤45 mm/hour. If no ESR was obtained, hip flexion ≤115° is substituted (sensitivity 86%, specificity 75%).

Clinical and radiographic diagnostic criteria:

• Hip pain plus 2 of the following 3 radiographic criteria: osteophytes (femoral or acetabular); joint space narrowing (superior, axial, and/or medial); ESR <20 mm/hour (sensitivity 89%, specificity 91%).