-60-90% of those >65 years

-20% of general population 

-most common cause of rheumatologic disease

-progressive loss of articular cartilage with associated remodeling of bone

-reactive bone formation = osteophytes, which can break off and calcify and cause swelling

-inflammation is local NOT systemic 

-can be primary or secondary

-biomechanical insults (repetitive joint trauma)

-biochemical (change in proteins/enzymes)

-inflammatory process 

-age, obesity, genetics, metabolic abnormals

**basically, anything that causes destruction of joint cartilage**

-associated w/ 4 patterns of disease

-idiopathic

-can be localized or generalized 

Heberden's or Bouchard's nodes

-involves PIP and DIP joints of hands

-much more common in women 

-strong familial component 

-may occur with or without nodal disease

-involves any other joint

-occurs in post-menopausal women

-affects PIP and DIP joints but spares the wrists 

-prominent, destructive changes 

-may suggest RA, need to rule this out

-any disease that may cause the bone to react as if it would in primary OA

-anything that alters integrity of bone and cartilage relationship 

-examples: severe joint injury*, septic arthritis, Paget's, gout, RA, hemophilia, congenital malformations

-localized joint pain and stiffness, slow onset

-increases with activity, improved w/ rest

-stiffness after prolonged inactivity

-joint-line tenderness and bony enlargement

-weather changes

-no serological abnormalities 

-based on hx, PE, radiographic features

-characteristic pattern of joint involvement and individual joint deformity (DIP,PIP, 1st metacarpal, facets of cervical & lumbar spine, hips, knees)

-wrist, elbows, shoulders, ankles uncommon

-usually no inflammatory signs, but may see effusion

-tailored to the individual with lifestyle modifications, pt. education, weight loss

-PT

-assistive devices

-orthotics

-analgesics, NSAIDS