10.7 Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis and typically affects weight-bearing joints such as the knees, hips, spine, and hands.
Risk factors for osteoarthritis include age, genetics, obesity, joint injuries, and occupations involving repetitive joint stress.[1] See Figure 10.34[2] for an image of a person with osteoarthritis in their finger.
Pathophysiology
Osteoarthritis is a degenerative joint disease characterized by the breakdown of joint cartilage and changes in the underlying bone. It occurs when cartilage wears away due to repetitive overuse of a joint and the inability of the cartilage to repair itself. As the cartilage breaks down, inflammatory processes within the joint occur as enzymes are released, causing the joints to swell and become stiff and painful. As the cartilage breaks down, osteophytes or bone spurs may occur, further restricting movement and causing additional pain. The joint spaces continue to narrow, resulting in reduced mobility and increased friction between the bones. Crepitus is a common symptom associated with osteoarthritis and is a popping, clicking, or crackling sound when moving a joint. It typically reflects air movement in the joint and is harmless.[3]
Assessment
While osteoarthritis primarily affects the musculoskeletal system, it can indirectly impact other body systems due to chronic pain, limited mobility, and the psychological toll it can take on an individual’s overall well-being. Assessment findings vary based on the severity and location of osteoarthritis. Common manifestations of osteoarthritis are summarized in Table 10.7a.
Table 10.7a. Manifestations of Osteoarthritis[4],[5],[6]
| Body System | Potential Assessment Findings |
|---|---|
| Musculoskeletal | Asymmetrical joint involvements with pain, especially after activity or prolonged rest; stiffness and reduced range of motion in affected joints; crepitus (grating or crackling sensation) with joint movement; and visible joint deformities or swelling |
| Integumentary | Warmth and redness over affected joints during periods of inflammation |
| Neurological | Numbness or tingling sensations due to nerve compression in affected joints |
| Psychological | Psychological impact such as anxiety, depression, or frustration due to chronic pain and limited mobility |
Diagnostic Testing
Diagnosis of osteoarthritis (OA) may include imaging studies and laboratory tests. X-rays may be ordered by the health care provider to visualize joint damage, joint narrowing, osteophyte formation, and potential changes in bone density. MRIs may also be ordered to examine soft tissue, cartilage breakdown, and the extent of joint damage. Laboratory tests, such as C-reactive protein and erythrocyte sedimentation rate, may also be ordered to rule out inflammatory arthritis.[7],[8] Review normal reference ranges for common diagnostic tests in “Appendix A – Normal Reference Ranges.”
Nursing Diagnoses
Nursing diagnoses associated with osteoarthr