Knee  OA Clinical manifestations

•       Age of onset → age> 40

•       Symptoms → Pain-Stiffness-Gelling

•       PE → Crepitus, Bony enlargement, Decreased range of motion, Malalignment, Tenderness to palpation, effusion

•       Radiography → Joint space narrowing, Subchondral sclerosis, Marginal osteophytes, Subchondral cysts

•       Synovial fluid analysis → Clear fluid, WBC <2000/mm3, Normal viscosity

•       Prognosis → Variable, generally slowly progressive

Patient complains

•       Symptoms → Pain-Stiffness-Gelling

•       Disability → varying degrees of physical disability, adversely affect quality of life

•       the most common cause of disability in adults.

•       in older 55 y in UK an incidence of 25 % per year, a prevalence of disability due to knee OA of 10 %, and severe disability in about 2 to 3 % [34].

•       Mortality →  excess all cause mortality than GP.

•       Risk factors :  a history of diabetes, cancer, or cardiovascular disease, and the presence of walking disability

OA DIGNOSIS

•    OA is frequently diagnosed by an overall clinical impression based upon the patient's age and history, findings on physical examination, and radiographic findings.

•       Methods  for evaluating possible OA of knee:

•       Tree model(Superior approach )

•       Traditional inclusion criteria method

•       Diagnosis based on background risk


Diagnosis based on background risk

patient’s risk factors for OA (eg, age, gender, BMI, occupation);

their symptoms (persistent knee pain, brief morning stiffness and functional limitation)

and an adequate physical examination (crepitus, restricted movement and bony enlargement).

Plain radiographs are the main test to consider, but are an adjunct, rather than a central feature, For purposes of diagnosis.

The higher the risk in the source population, the more possible it is to diagnose knee OA based on clinical features