Knee osteoarthritis classically presents with joint pain that is exacerbated by use and alleviated with rest. There is relatively brief, self-limited morning stiffness and absence of constitutional symptoms. Overweight and obesity are the most important modifiable risk factors. Although pharmacologic and nonpharmacologic interventions are generally effective at alleviating pain and improving physical function, they do not fundamentally reverse the pathologic and radiographic process of knee osteoarthritis. As the severity of disease progresses, the magnitude of pain and functional impairment intensifies. Surgical intervention should be pursued to relieve pain and restore functionality only when nonpharmacologic approaches and pharmacologic agents fail to control pain.
Use this to:
- Consult a rheumatologist to discuss his or her approach to a patient who presents with symptoms consistent with knee osteoarthritis. When would they recommend that a primary care physician refer patients with suspected osteoarthritis to a rheumatologist? What actions or tests are helpful before referral?
- Review the appropriate prescription of nonpharmacologic and pharmacologic therapy for knee osteoarthritis.
- Take the quiz that accompanies the article to assess your knowledge, and then review the correct answers.
In the Clinic is a feature of Annals of Internal Medicine which includes practical reviews about the management of common clinical conditions.
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