الفُصال العظمي

Definition

Osteoarthritis is the commonest joint disease: gradual wear of joint cartilage with changes in the bone beneath.

Most affected joints

Knees, hips, finger joints and the spine, mostly weight-bearing joints.

Risk factors

Age, obesity, previous injury, repetitive strain and genetics.

Symptoms

• Pain worse with use, better with rest
• Brief morning stiffness under 30 minutes
• Crepitus and bony enlargement
• In the hand: Heberden’s and Bouchard’s nodes

Diagnosis

Clinical; X-ray shows joint-space narrowing and osteophytes.

Treatment

• Weight loss and strengthening exercise matter most
• Paracetamol, topical or oral NSAIDs with care
• Intra-articular steroid injections for flares
• Joint replacement when advanced

Nursing care

• Encourage regular, non-straining activity
• Use a cane in the hand opposite the affected joint

Exam point

Versus rheumatoid arthritis: OA has brief, asymmetric morning stiffness; RA has stiffness over an hour and is symmetric.