Osteoarthritis

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How Is Osteoarthritis Diagnosed?

Early diagnosis is essential for managing osteoarthritis effectively and preventing its progression. Healthcare providers use a combination of physical examinations, imaging techniques, and laboratory tests to confirm osteoarthritis and differentiate it from other joint-related conditions.

At Subang Jaya Medical Centre (SJMC), our team of orthopaedic specialists ensures a thorough and accurate diagnosis using the latest diagnostic tools.

Physical Examination

During the physical examination, the affected joint is assessed for:

  • Tenderness: Pain upon touch or pressure.
  • Swelling: Inflammation in and around the joint.
  • Flexibility: Evaluating the range of motion in the joint.

A detailed orthopaedic assessment helps to identify the severity of the condition and guide further tests or treatments.

Imaging Tests

Imaging is a crucial part of diagnosing osteoarthritis, helping to visualise joint damage and assess the severity of cartilage loss.

  • X-rays: These provide clear images that show cartilage loss, joint space narrowing, and the presence of bone spurs, which are indicative of osteoarthritis. Radiologists play a key role in interpreting these images.
  • Magnetic Resonance Imaging (MRI): An MRI offers detailed images of both bones and soft tissues, including cartilage. It is particularly useful in complex cases or when evaluating other joint tissues. Orthopaedic specialists often recommend an MRI for detailed visualisation of joint structures.

Laboratory Tests

While osteoarthritis is primarily diagnosed through imaging, laboratory tests help rule out other conditions and evaluate the joint's health:

  • Blood Tests: These are used to rule out conditions like rheumatoid arthritis, which may cause similar symptoms. Rheumatologists are involved in diagnosing and managing autoimmune-related joint disorders.

  • Joint Fluid Analysis: This test is done by extracting fluid from the affected joint to check for signs of infection or inflammatory arthritis, such as gout.

Treatment Options for Osteoarthritis

While osteoarthritis is a degenerative condition with no cure, various treatments can help manage symptoms, improve mobility, and enhance the quality of life. Treatment plans at SJMC are tailored based on the severity of the condition and the patient's overall health.

Medications

Medication is often the first line of treatment for osteoarthritis to reduce pain and inflammation:

  • Paracetamol: Often the first treatment for mild to moderate pain. Overuse can be harmful to the liver, so it should be taken as directed by a primary care physician.
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These medications help reduce pain and inflammation. Topical NSAIDs may be used to reduce side effects, especially for knee osteoarthritis.
  • Duloxetine: Originally an antidepressant, it is also approved for chronic pain management, particularly in knee and hip osteoarthritis.

Therapy

Non-surgical treatments play an essential role in managing osteoarthritis:

  • Physical Therapy: Physical therapists work with patients to strengthen muscles around the affected joint, improve joint mobility, and reduce pain.
  • Occupational Therapy: Occupational therapists help patients adjust their daily activities to reduce strain on the affected joints, making tasks like dressing or cooking easier.
  • Transcutaneous Electrical Nerve Stimulation (TENS): This method provides short-term pain relief for osteoarthritis, particularly in the knee and hip joints.

Surgical and Interventional Procedures

When conservative treatments do not provide relief, surgical options may be considered:

  • Cortisone Injections: These injections provide temporary relief by reducing inflammation around the joint.
  • Lubrication Injections (Hyaluronic Acid): These injections add lubrication to the joint, mimicking the natural joint fluid and reducing friction, though their effectiveness may vary.
  • Total Knee Replacement (TKR): This involves replacing the damaged knee joint with a prosthesis made of metal and plastic, offering long-lasting relief for those with severe knee osteoarthritis. Orthopaedic surgeons specialise in performing TKR.
  • Total Hip Replacement (THR): Similarly, THR involves replacing the damaged hip joint with a prosthetic, providing relief for patients with severe hip pain.

Self-Care and Lifestyle Modifications

Adopting certain lifestyle changes can have a significant impact on managing osteoarthritis:

  • Exercise: Regular low-impact activities like walking, swimming, and cycling can help maintain joint function and improve strength.
  • Weight Management: Even a modest weight loss can relieve pressure on weight-bearing joints like the knees and hips. Dietitians can offer nutritional advice to support weight management.
  • Heat and Cold Therapy: Applying heat can relax muscles, while cold packs can reduce inflammation and swelling around the joints.
  • Assistive Devices: Orthopaedic specialists may recommend canes, walkers, or joint braces to support mobility and reduce stress on affected joints.

Benefits of Total Knee and Hip Replacement

For patients with advanced osteoarthritis, Total Knee Replacement (TKR) and Total Hip Replacement (THR) offer substantial benefits:

  • Pain Relief: These surgeries eliminate or significantly reduce joint pain.
  • Improved Mobility: Patients can regain the ability to perform daily activities and improve overall movement.
  • Enhanced Quality of Life: After surgery, many patients experience a significant improvement in their quality of life, allowing them to resume physical activities.
  • Long-Lasting Results: With proper care, joint replacements can last 15–20 years or more, offering long-term relief.

FAQs About Osteoarthritis Diagnosis and Treatment

Recovery time varies, but most patients can return to normal activities within 6–12 weeks after total knee or hip replacement surgery.

Yes, options like cortisone injections, physical therapy, and hyaluronic acid injections can help manage symptoms without surgery.

Total hip replacement surgery has a high success rate, with over 90% of patients experiencing significant pain relief and improved mobility.

In total hip replacement, both the ball and socket of the hip joint are replaced, while partial hip replacement only replaces the femoral head (the ball). Total hip replacement is more common in severe osteoarthritis cases.

Total knee replacement provides pain relief, improved mobility, and the ability to resume activities like walking and swimming. The prosthetic joint can last for 15–20 years or more with proper care.

Delaying surgery can lead to worsening joint damage, increased pain, and reduced mobility. Over time, delaying surgery may limit its effectiveness, making early intervention important.

Yes, osteoarthritis can affect multiple joints, especially weight-bearing joints like the knees, hips, and spine. It can also occur in smaller joints, such as those in the hands. Treatment plans are tailored based on the number and severity of joints affected.

Reference:

  1. Mayo Clinic Osteoarthritis: Diagnosis and Treatment
  2. Johns Hopkins Medicine Osteoarthritis Overview
  3. Harvard Health Publishing: Osteoarthritis
  4. Arthritis Foundation Malaysia: Osteoarthritis Information
  5. Healthdirect Australia: Osteoarthritis
  6. Cleveland Clinic Osteoarthritis: Diagnosis and Tests