Clinically, osteoarthritis can be divided into two categories: primary osteoarthritis, which is osteoarthritis whose cause cannot be detected by all current examination methods, usually referred to as osteoarthritis belongs to this category. 2. Secondary osteoarthritis refers to lesions induced by various other causes or diseases, such as trauma, rheumatoid arthritis, neurological and endocrine diseases, etc. This type of osteoarthritis is more limited and is not accompanied by “Herbertian nodes”. People who repeatedly strain their joints are at high risk for osteoarthritis, such as foundry workers, miners, and bus drivers, but people who run and exercise are not at high risk for this disease. Obesity is a major factor in osteoarthritis, but the evidence is not yet sufficient. Common sites and features 1. Hands: The interphalangeal joints are most commonly involved, especially the distal interphalangeal joints. Swelling and pressure pain are less pronounced and rarely affect joint motion. The characteristic change is the formation of a hard nodule with bony hyperplasia on the medial and lateral surfaces of the dorsal surface of the 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. 2. Knee: Knee pain is a common complaint of patients with this disease. Early symptoms are pain when going up and down stairs, especially when going downstairs, either unilaterally or bilaterally, and joint enlargement, mostly due to bony hypertrophy, or joint effusion. Synovial hypertrophy is rare. In severe cases, the knee is inversion deformity. 3, hip: manifested as pain in the greater trochanter, lateral hip, groin, etc., which may radiate to the knee. The internal rotation and extension activities of the hip are limited. Osteoarthritis of the hip occurs less in our population than in Caucasians. 4, foot: the first toe joint is the common site of lesions. Wearing tight footwear and repeated trauma are its causes. Symptoms are localized pain, bony hypertrophy and bunions. 5, spine: degenerative lesions of the vertebrae, intervertebral discs, and synovial joints cause lesions of the vertebrae in the cervical and lumbar segments. Local pain and stiffness occur. In a few severe cases, a variety of radiological pain or neurological symptoms occur due to lipoid hyperplasia of the vertebral body edge and bone arthrosis compressing local nerve roots, spinal cord or local blood vessels. Treatment: Non-steroidal drugs (NSAIDs) are the most commonly used in clinical practice, including ibuprofen (Fentanyl), diclofenac (Fotaralin), meloxicam (Mupirocort), and nebumetone (Relifen). They have definite efficacy, but side effects are also more obvious, such as gastrointestinal adverse reactions and renal impairment. The specific cyclooxygenase-2 inhibitors (Cilazol, etc.) are safer compared with the previous drugs, but they should be used with caution in both the elderly and patients with cardiovascular disease. In addition, people commonly use acetaminophen (paracetamol), which has only antipyretic and analgesic effects, few anti-inflammatory effects, low nephrotoxicity and small gastrointestinal adverse reactions, is also an important drug for acute and chronic pain treatment. Nerve block therapy, divided into external block of joint cavity and internal block of joint cavity, treatment of soft tissue outside the joint cavity can release adhesions and restore normal tissue activity. Injection of sodium hyaluronate inside the joint cavity can increase the lubricating function of synovial fluid, nourish joint cartilage and promote the repair of joint cartilage. Injections are given once a week, 30 mg each time, for a course of 5 times. There are many other treatments, including health education for patients, self-training, weight loss, aerobics, joint mobility training, muscle strength training, use of mobility aids, wedge walking insoles for internal knee rolls, occupational therapy and joint protection, aids for daily life, etc. If the symptoms of osteoarthritis are very severe, medication is ineffective, and it affects the patient’s daily life, surgical intervention should be considered.
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