Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 715 Osteoarthrosis and allied disorders715.14 Osteoarthrosis localized primary involving hand715.24 Osteoarthrosis localized secondary involving hand715.9 Osteoarthrosis unspecified whether generalized or localized715.94 Osteoarthrosis unspecified whether generalized or localized involving hand ++ M19.049 Primary osteoarthritis, unspecified handM19.249 Secondary osteoarthritis, unspecified handM18.9 Osteoarthritis of first carpometacarpal joint, unspecified ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction4F: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, and Reflex Integrity Associated With Spinal Disorders4H: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Joint Arthroplasty4I: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Bony or Soft Tissue Surgery +++ Description ++ Most common form of Osteoarthritis (OA)DegenerativeCommonly affects hand and weight-bearing jointsCan also affect interphalangeal joints and first metatarsophalangeal jointAssociated with increasing age, obesity, sex and race/ethnicity Associated with abnormal loading of the jointsCharacterized by joint painArthrosisOsteoarthrosisPolyarthrosisDegenerative joint disease +++ Essentials of Diagnosis ++ Radiography is a standard method for diagnosisKellgren and Lawrence (KL) grade ≥ 2 (definite radiographic OA)2Osteophytes, joint-space narrowing, sclerosisAlso cartilage lesions, bone marrow lesions, synovitis, effusion, and subchondral bone attrition/sclerosisErosion of articular cartilageSynovial hyperplasiaFibrosisInflammatory cell infiltrationConventional radiograph is the most commonly used tool in OA. Diagnosis is made based on a careful history taking, physical examination, imaging studies, laboratory examination, and exclusion of other possible diseases. +++ General Considerations ++ Low bone mineral density (BMD)Repetitive joint use or loadingJoint alignmentBone or joint morphologyCalcification (e.g., of the knee meniscus)Bone formation, cyst formationThickening of subchondral bone plate, osteosclerosisOverall joint dysfunctionJoint swelling and inflammation (in certain cases, severe cases)Joint painMorning stiffnessLong-term disease Secondary problems Muscle atrophy and weaknessBony protrusion/prominenceJoint deformityGrasping difficultyDifficulty with ADLs +++ Demographics ++ Increase in age (middle to older age)Women are more affected than menAfrican American and CaucasianMay affect about 12% of the population (US and other developed countries)3 +++ Signs and Symptoms ++ Joint painAching jointJoint stiffnessMuscle weaknessMuscle atrophyCrepitusBony enlargementLimited joint ROMJoint line tendernessJoint deformity in severe casesActivity limitationHeberden’s nodes +++ Functional Implications ++ Limited mobilityHousehold- and work-related activity limitation/restrictionDecreased overall activity and participation +++ Possible Contributing Causes ++ Chronic factors affecting the joint such as obesity, BMD, and leg length discrepancy (LLD)AgingChronic and vigorous joint loadingPrevious chronic joint injury (e.g. accident, trauma), hence secondary Osteoarthritis (OA) +++ Differential Diagnosis ++ Rheumatoid ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.