The process of diagnosing OA combines a detailed medical history, physical examination, imaging studies, and sometimes laboratory tests to accurately assess the condition and its severity.

1. Medical History: The doctor begins by discussing the patient’s symptoms, including the location and duration of joint pain, stiffness, swelling, and any factors that worsen or alleviate symptoms. They also inquire about past injuries, surgeries, and family history of arthritis, which can provide valuable insights into predisposing factors.

2. Physical Examination: A comprehensive physical exam focuses on assessing the affected joints for tenderness, swelling, warmth, and visible deformities. The doctor evaluates joint function, range of motion, and any signs of instability or crepitus (a crackling or grating sensation).

3. Imaging Studies: X-rays are typically the first-line imaging modality used to confirm a diagnosis of OA. X-rays can reveal characteristic joint changes such as narrowing of joint spaces, osteophytes (bone spurs), and sclerosis (increased bone density) around the affected joint. These findings help differentiate OA from other types of arthritis and assess the extent of joint damage.

4. MRI and CT Scans: In some cases, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be recommended to provide more detailed images of the joint structures, particularly useful when assessing soft tissues like cartilage and ligaments.

5. Joint Aspiration: If there is uncertainty about the diagnosis or suspicion of another condition like gout, joint aspiration (arthrocentesis) may be performed. A small sample of fluid is extracted from the affected joint and analysed for the presence of crystals, blood, or signs of infection.

Treating osteoarthritis (OA) involves a combination of approaches aimed at reducing pain, improving joint function, and enhancing overall quality of life. The treatment plan is tailored to each patient based on the severity of symptoms, joint involvement, overall health, and individual preferences.

1. Medications: Pain management is a cornerstone of OA treatment. Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are commonly used to alleviate pain and reduce inflammation. For those with more severe pain, prescription NSAIDs or topical treatments like creams or patches containing NSAIDs or capsaicin may be recommended.

2. Injections: Corticosteroid injections directly into the affected joint can provide significant pain relief and reduce inflammation, particularly useful during OA flare-ups. Hyaluronic acid injections, also known as viscosupplementation, may be offered for knee OA to lubricate the joint and improve mobility.

3. Physical Therapy: A structured exercise program designed by a physical therapist helps improve joint flexibility, strengthen muscles supporting the affected joints, and enhance overall mobility. Physical therapy also includes techniques to improve posture, gait, and joint protection strategies to minimise stress on the joints.

4. Lifestyle Modifications: Patients are encouraged to make lifestyle changes that can help manage OA symptoms and improve joint health. These may include weight management to reduce stress on weight-bearing joints, incorporating low-impact exercises like swimming or cycling, and using assistive devices such as splints or braces to support joints during daily activities.

5. Surgical Interventions: When conservative treatments fail to provide relief or joint damage is severe, surgical options may be considered. Arthroscopic surgery may be performed to remove damaged tissue or debris from the joint, while joint realignment procedures (osteotomy) or joint replacement surgery (arthroplasty) such as knee or hip replacement may be necessary to restore function and alleviate pain.

The goal of osteoarthritis treatment is to minimise pain, improve joint function, and preserve mobility to enable patients to maintain an active and independent lifestyle.