The disease has a slow onset. Symptoms tend to appear after the age of 40, with an increase in onset with age. The incidence is higher in women than in men. Arthralgia in this disease has the following characteristics: it is mostly found in weight-bearing joints such as knees and hips; arthralgia is related to activity, and the pain is relieved after rest; after the joint has been stationary for a long time and then moved, there is a transient local stiffness that lasts no more than 30 minutes and disappears after activity; in severe cases, there is arthralgia and limitation of activity even at rest; the affected joints are often accompanied by pressure pain, bony hypertrophy, bony friction sounds, and a few patients have deformities. A small number of patients have deformities. The common sites of osteoarthritis and their characteristics are as follows. More than one site may be present in the same patient. The interphalangeal joints are most commonly involved, especially the distal interphalangeal joints. Swelling and tenderness are less pronounced and rarely interfere with joint motion. The characteristic change is a hard nodule with bony growths on the medial and lateral surfaces of the dorsal phalanges, called Heberden’s nodule in the distal interphalangeal joint and Bouchard’s nodule in the proximal interphalangeal joint. These nodules develop very slowly. Only a small number of patients eventually develop a flexion or external oblique deformity of the distal phalangeal joint. When the first carpometacarpal joint is involved and there is osteophyte growth, a “square” shaped hand is formed, which is rare in the Chinese population. Knee Knee pain is a common complaint of patients with this disease. Early symptoms are pain when going up and down stairs, especially when descending, either unilaterally or bilaterally, and joint enlargement, mostly due to bony hypertrophy, or fluid in the joint cavity. Synovial hypertrophy is rare. In severe cases, inversion of the knee may occur. The hip presents with pain in the greater trochanter, lateral hip, and groin, which may radiate to the knee. Internal rotation and extension of the hip are limited. Osteoarthritis of the hip occurs less frequently in our population than in Caucasians. Foot The first toe joint is a common site of lesions. Wearing tight footwear and repeated trauma are the causes. Symptoms are localized pain, bony hypertrophy, and bunions. Spine Degenerative lesions of the vertebrae, intervertebral discs, and synovial joints cause lesions of the vertebrae in the cervical and lumbar segments. Localized pain and stiffness occur. In a few severe cases, various radiological pain or neurological symptoms occur due to labral hyperplasia and bony arthrosis at the vertebral body margin compressing local nerve roots, spinal cord or local blood vessels.