[Osteoarthritis. Pathogenesis, clinical features and treatment].

Osteoarthritis (OA) is the most common joint disease and one of the most common diseases altogether. Everybody above 60 years of age has pathological features of OA in at least one joint. Loss of articular cartilage is a crucial event in OA. Concomitant features are osseous deformation and sclerosing, shrinkage of the capsule, atrophy of muscles, and variable degrees of synovitis. The cardinal symptom of OA is pain. Later, deformation and malalignment with deprived function of the joint are seen. The clinical and radiological features make up the diagnosis. Patients with all grades of OA should be given information and physical therapy. Paracetamol is the first drug of choice. If paracetamol is insufficient to achieve pain control or inflammation is present, COX-2 specific inhibitors should be considered. If effusion is present, an intra-articular injection of long-acting steroid may be administered. Severe OA of the hip or knee is treated with arthroplastic surgery, but precise indications for surgery need to be established.