Rheumatology

Osteoarthritis

Degenerative joint disease with progressive articular cartilage loss, subchondral sclerosis and osteophyte formation; most common cause of chronic joint pain.

Last reviewed 10 Jun 2026 - MedicoMedics editorial team

Pathophysiology

Mechanical stress, obesity, age, prior injury and genetic factors drive chondrocyte apoptosis and matrix breakdown; low-grade synovitis contributes.

Sources: ACR/AF OA 2019 (Arthritis Care Res 2020;72:149); Lancet 2019;393:1745

Presentation

Insidious activity-related joint pain, morning stiffness <30 min, crepitus, restricted range; Heberden (DIP) and Bouchard (PIP) nodes; knees, hips, base of thumb, spine most affected.

Diagnosis

Clinical; radiographs show joint-space narrowing, subchondral sclerosis, osteophytes and cysts. Inflammatory markers normal.

Management

Non-pharmacologic: weight loss, exercise, physical therapy. Pharmacologic: topical NSAIDs (knee), oral NSAIDs, duloxetine, intra-articular corticosteroid (short-term), avoid opioids. Surgical: total joint arthroplasty for end-stage.

Sample USMLE-style MCQs

Try 5 questions on this topic. Practice hundreds more free with a trial.

Question 1

A 65-year-old with knee pain worse with activity and Heberden nodes. Best first-line pharmacotherapy?

Question 2

Which radiographic finding is characteristic?

Question 3

Definitive therapy for end-stage hip OA?

Question 4

Which drug should be avoided in chronic OA per current guidelines?

Question 5

A patient with knee OA has effusion; joint aspiration shows non-inflammatory (<2000 WBC) fluid. Consistent?

References

Primary guidelines and peer-reviewed sources used for this entry. Reviewed 10 Jun 2026 by MedicoMedics editorial team.

Frequently asked

Morning stiffness duration in OA vs RA?

OA <30 min, RA >1 h.

Which node is DIP?

Heberden node.

Best exercise?

Low-impact strengthening (quadriceps for knee OA).

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