Osteoarthritis is a common cause of localized or widespread joint pain in adults, with a slow onset, often asymptomatic, and benign progression. Advanced stages of the disease can present with significant pain, stiffness, and limited joint motion, leading to joint disuse. The causes of pain from osteoarthritis are not fully elucidated and may be related to factors such as synovitis, bone proliferation, increased intra-articular venous pressure, capsular distension, irritation of ligaments and tendon tissue, and subchondral bone fractures. Osteoarthritis is a lifelong disease, but it does not necessarily progress or become more symptomatic. There is no evidence that early detection of the disease can alter its course, yet early intervention facilitates functional preservation. Symptoms of osteoarthritis 1. Pain: This is usually the initial complaint of patients with osteoarthritis and occurs early in the course of the disease after overuse of the joint. As the disease progresses, pain may also occur at rest. Cold and moisture can make the pain worse. 2. Stiffness: It is the feeling of tightness and slow movement of the joint. Stiffness is not necessarily associated with objective limitation of joint movement. Typical episodes are in the morning and resolve in 15-30 minutes. Stiffness in rheumatoid arthritis can last much longer. Stiffness, like pain, can be exacerbated by a drop in atmospheric pressure or an increase in humidity. 3. Weakness and loss of use: weakness may correlate with the degree of arthritis, and loss of use represents a poor prognosis because of limited joint movement due to arthritis. For the knee and hip joints, claudication is a common sign of disuse. Signs of osteoarthritis 1. pressure pain: most of the joint pressure pain is at the joint line. 2.Joint enlargement: It can be due to bony protrusion, synovitis, and exudate. Skin fever and erythema are rare. 3.Sense of joint friction: Because of irregularity of joint surface and debris in the joint, it produces sound when moving. 4. Restriction of movement: Moderate to severe arthritis restricts joint movement. The causes are pain, inflammation, flexion contracture, free bodies, and deformity. 5.Deformity: caused by flexion contracture, poor alignment, subluxation, and joint enlargement. Primary arthritis can involve one or more joints, the most common are knee arthritis, proximal interphalangeal arthritis, distal interphalangeal arthritis, first carpometacarpal arthritis, also seen in the small joints of the spine, hip, acromioclavicular joint, and first metatarsophalangeal joint. The onset of the disease is mostly slow, with a few acute onset. It may start with a minor joint sprain, and the joint pain lasts for a month or several months, beyond the duration of the soft tissue injury. The onset may also occur in cold weather, on rainy days, or after climbing or walking long distances, mostly without a trigger. Chronic asymmetric monoarticular onset is characteristic of osteoarthritis, which progresses to chronic asymmetric polyarthritis.
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