Principal manifestations of osteoarthritis

Patient characteristics
Age of onset	>40 years*
Symptoms
Pain	Affects one or a few joints at a time Insidious onset - slow progression over years Variable intensity May be intermittent Increased by joint use and relieved by rest Night pain in severe osteoarthritis
Stiffness	Short-lived (<30 minutes) and early morning- or inactivity-related
Swelling	Some (eg, nodal osteoarthritis) patients present with swelling and/or deformity
Constitutional symptoms	Absent
Physical exam findings
Appearance	Swelling (bony overgrowth ± fluid/synovial hypertrophy) Attitude Deformity Muscle wasting (global - all muscles acting over the joint)
Palpation	Absence of warmth Swelling (effusion if present is usually small and cool) Joint line tenderness Periarticular tenderness (especially knee, hip)
Range of motion	Crepitus (knee, thumb bases) Reduced range of movement Weak local muscles

OA: osteoarthritis.
* Major joint injury and certain rare conditions may predispose to OA before the age of 40 years.

Adapted from: OARSI Primer (http://primer.oarsi.org).

Graphic 108692 Version 1.0