How To Diagnose Osteoarthritis & What Is The Best Medicine For It?

The chronic affection of the articulations or arthritis evolves over the years in a more or less rapid way according to the patients. This pathology can induce a significant handicap when it is localized at the level of the knee or the hip. To diagnose the chronic condition, the patient must essentially undergo a clinical examination . (1)

How To Diagnose Osteoarthritis?

The diagnosis of osteoarthritis begins by questioning the symptoms. This state consists of obtaining precious information on the nature and intensity of the pain felt by the patient and the presence of a joint gene. Osteoarthritis is diagnosed after carefully examining the patient.

The doctor will also deepen the analysis of the disease by determining the triggering of the pain. Is the discomfort triggered by pressure or during movement of the affected limb? The diagnosis of osteoarthritis is also made by evaluating the importance of joint stiffness by detecting a sign such as swelling of a joint.

Most patients with osteoarthritis experience arthritis pain that is triggered with exertion. The violent stitches calm down when the ankylosed member is at rest. Note that some arthritis can be accompanied by painful inflammatory flares capable of waking the patient overnight. Inflammatory flares generate morning rust. (2)

Radiological Signs Confirming The Diagnosis Of Osteoarthritis

When osteoarthritis has evolved a lot, the x-ray of the affected area can show erosion of the subchondral bone. This phenomenon is observed in the part where the cartilage has disappeared. The main radiological signs capable of diagnosing the chronic affection are – a pinching of the joint space, the presence of osteophytes which are bony growths located around the joint. Bone condensation and the presence of geodes are all radiological signs that confirm the diagnosis of osteoarthritis.

There are no particular biological signs that can confirm the diagnosis of the joint condition. Generally, radiography is the only examination capable of confirming the presence of osteoarthritis and guaranteeing the follow-up of the pathology. Additional exams can also be performed. Examples are CT, bone scintigraphy, arthrography, MRI, ultrasound or arthroscopy. (3)

Summary Of Procedures For A Diagnosis Of Osteoarthritis

The diagnosis of osteoarthritis takes place in several stages. Doctors start with the interrogation of the pain and discomfort of the joint which appeared gradually. The clinical examination makes it possible to detect the development of the disease in more detail. Confirmation of the diagnosis is made by simple additional examinations. The X-ray can detect the main features of osteoarthritis. (2)

What Is The Best Medicine For Osteoarthritis?

Medicines containing paracetamol are recommended first. In the treatment of osteoarthritis, paracetamol can be taken at a dose of 1 gram, four times a day, but only on medical prescription. Paracetamol is usually well tolerated. However, an overdose can be toxic to the liver. Care must be taken not to exceed the prescribed doses and not to combine several drugs containing paracetamol. If taking oral anticoagulant therapy and taking a dose of four grams of paracetamol daily for four days or more, increased monitoring of anticoagulant therapy may be necessary.

Nonsteroidal Oral Anti-Inflammatory Drugs: Certain nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and ketoprofen, or aspirin can be obtained without a prescription for pain relief, but they should not be used for more than a few days without notice.

Non-Steroidal Anti-Inflammatory Drugs In Gel Form: Certain anti-inflammatory drugs (NSAIDs) in the form of a gel for the local application can be used to relieve arthritis pain in small joints (fingers, knees, etc.). They do not expose to the digestive side effects of oral NSAIDs. The ketoprofen-containing gels are nevertheless likely to cause photosensitivity reactions. The areas treated with the gel must be covered with a garment so as not to be exposed to the sun, even when veiled, for the entire duration of the treatment and during the next 15 days following its cessation.

Opiate And Morphine Pain Relievers: The doctor may prescribe more powerful pain medications: opiate derivatives (codeine, tramadol) alone or in combination with paracetamol, or as a last resort, morphine, and its derivatives.

Intra-Articular Corticosteroid Injections: Glucocorticoids, or corticosteroids, are synthetic products derived from cortisone, a hormone secreted by the adrenal glands. Glucocorticoids are also called corticosteroids. They reduce the characteristic signs of the inflammatory reaction (heat, redness, and swelling). Glucocorticoids are prescription drugs.

Slow-Acting Antiarthritic And Other Drugs: Other drugs are sometimes prescribed to preserve the cartilage: Chondroitin sulfate, glucosamine, diacerein, avocado, and soy. Following the reassessment of their medical service rendered by the health authorities, they are no longer reimbursed by Health Insurance. Some of these substances (glucosamine, chondroitin, etc.) are also present in food supplements. (4) (5)

References:

  1. Guan VX, Mobasheri A, Probst YC. A systematic review of osteoarthritis prevention and management with dietary phytochemicals from foods. Maturitas. 2019;122:35-43.
  2. Iolascon G, Gimigliano F, Moretti A, et al. Early osteoarthritis: How to define, diagnose, and manage. A systematic review. European Geriatric Medicine. 2017;8(5-6):383-396.
  3. Thomson J, O’Neill T, Felson D, Cootes T. Detecting osteophytes in radiographs of the knee to diagnose osteoarthritis. Paper presented at: International Workshop on Machine Learning in Medical Imaging2016.
  4. Newberry SJ, FitzGerald J, SooHoo NF, et al. Treatment of osteoarthritis of the knee: an update review. 2017.
  5. de Meneses SF, Rannou F, Hunter DJ. Osteoarthritis guidelines: Barriers to implementation and solutions. Annals of physical and rehabilitation medicine. 2016;59(3):170-173.

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