The physician considers the diagnosis of osteoarthritis to the pain, difficulty in carrying out joint movements, discomfort in walking, and swelling (or deformation) of a joint. But, only the x-ray of the joint showing characteristic images can confirm the diagnosis. The pain is the main symptom.
It is a pain qualified as mechanical because it increases as soon as the joint is mobilized or loaded and relieved by rest. It is stronger at the end of the day but does not wake the patient up at night. The pain is associated with stiffness of the joint. This association is responsible for discomfort when walking (in cases of osteoarthritis of the knee or hip) or in the mobilization of the fingers in case of digital osteoarthritis. The doctor who examines a patient with osteoarthritis like knee arthritis (กล้าม เนื้อ เข่า อักเสบ which is the term in Thai) finds:
- a decrease in joint mobility, especially when osteoarthritis seat at the large joints;
- the deformation of the joints, in particular, those of the fingers (finger osteoarthritis);
- a possible increase in the volume of the knee concerning the presence of fluid in the joint.
X-rays reveal characteristic images of osteoarthritis:
- pinching of the joint space (reduction of the space between the two bones making up the joint);
- changes in the structure of the bone immediately below the cartilage;
- bone expansions at the junction between bone and cartilage (parrot beaks or osteophytes).
There are several types of medications prescribed for osteoarthritis. Some are administered orally. These are:
- the analgesics first and foremost FIG paracetamol;
- the anti-inflammatories prescribed for a few days during painful acute attacks;
- The anti-arthritic symptomatic slow-acting is recommended for several months in osteoarthritis of the knee or hip; they act after a few weeks delay.
Others are applied or injected locally. These are:
- the ointments or gels based on anti-inflammatory damage in the small joints;
- the corticosteroids and hyaluronic acids injected into the knee joint.
The placement of a prosthesis is indicated for the hip and knee joints when non-drug measures and drugs are no longer sufficient to maintain the patient an acceptable quality of life.