Osteoarthritis

Dr.
Ahmad SYAN OPD HUB

CEO Medicinology & Author
Learn Best Disease
Pg Medicine, Ex Director Licensing Dept.
Management Skills
Medical Instructor & MedTech Expert
Chief Advisor in Organics Pharmaceuticals
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
+92 309 9726054

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Dr. Ahmad SYAN OPD HUB
Learn Best Disease
Management Skills
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
+92 309 9726054

Learn Best Disease
Management Skills
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
+92 309 9726054

Dr. Ahmad SYAN
OPD HUB
Learn Best Disease
Medical Instructor & MedTech Expert Management Skills
Waqas 5/8/2024 50
Male
Diagnosis:
OSTEOARTHRITIS
CASE: Vitals
a 65-year-old retired teacher, visits her primary care

physician complaining of persistent pain and stiffness in
her knees, particularly worsening after prolonged periods
of standing or walking. She reports that the pain has
been progressively getting worse over the past few years, P/C
limiting her ability to enjoy her daily walks and perform
household chores comfortably. On examination, there are
crepitus and tenderness on palpation of both knees, along
with decreased range of motion. X-rays reveal joint space
narrowing, osteophyte formation, and subchondral sclerosis
consistent with osteoarthritis.
❖ It is a degenerative disease of joints. It is seen in old On Examination
age and mostly affects weight bearing joints (knee and
hip) and axial skeleton
Several factors contribute to the development of
osteoarthritis, including Respiratory
▪ age,
▪ genetics,
GIT
▪ joint overuse or injury,
▪ obesity, and
▪ joint misalignment.
CNS
Presenting complaints:
CVS
Comorbs
+92 309 9726054

Learn Best Disease
Medical Instructor & MedTech Expert Management Skills
Waqas 5/8/2024 50
Male
Diagnosis:
OSTEOARTHRITIS
• Patient presents with pain in the joint, particularly on movements.

• It commonly involves hands, hips and knee joints
• There is history of morning stiffness lasting less than 15 mins
History questions:
o When did you first notice the joint pain or stiffness?
o Which joints are affected, and does the pain stay localized or spread to other
areas?
o Can you describe the type of pain you're experiencing?"
o What makes the pain better or worse?"(Resting helps a bit, but it really
flares up with activity or prolonged standing)
o Do you experience stiffness in the joints, particularly in the morning?
(Patient of osteoarthritis may have morning stiffness of less than 15 mins )
o Have you had any previous injuries or trauma to the affected joints?
o Does anyone in your family have a history of arthritis or joint problems?"
o Has the joint pain affected your ability to perform daily activites??
o Do you have any other medical conditions, and are you taking any
medications?".
Examination:
Vitals:
Take Vitals (Bp,pulse, temperature, respiratory rate)
Inspection:
Inspect for joint deformity, swelling, or asymmetry. (Joint may be
swollen and deformed)
+92 309 9726054

Learn Best Disease
Management Skills
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
Assess the range of motion:
In affected joints, noting any limitations or stiffness.

(Movements may be limited)
Palpate:
Palpate the joint for tenderness, warmth, or bony enlargement (osteophytes).
Crepitus may be palpable
Evaluation of muscle strength:

Evaluate muscle strength around the affected joint, as weakness may occur due
to disuse or pain inhibition. Observe the patient's gait for abnormalities such as
limping or favoring one side.
❖ Hard, bony nodules on the finger joints (Bouchard's nodes on the proximal
interphalangeal joints and Heberden's nodes on the distal interphalangeal
joints), indicative of hand osteoarthritis.
Investigations:
➢ ESR and leukocyte count are normal.
➢ X-ray joint shows reduced joint space and osteophytes.
➢ Periarticular sclerosis and cyst formation are common.
Treatment of Osteoarthritis
+92 309 9726054

Learn Best Disease
Management Skills
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
Non pharmacological intervention

Weight management: Maintain a healthy weight to reduce stress on joints.
Exercise: Regular low-impact activities like walking, swimming, or cycling.
Physical therapy: Targeted exercises and manual therapy to improve joint
flexibility and strength.
Pharmacologic intervention
▪ X-rays spine show reduced disc space.

▪ Myelogram demonstrates site of herniation.
▪ MRI is more informative, shows detailed anatomy and is the
investigation of choice.
Salt Brand Dose Price

Painkillers (Oral Synflex/Naproxen/flexing 1 tablet BD Rs.17/14/15
NSAIDS) Tab Pytex /Brexin 20mg for 5 days
Tab Naproxen sodium
500mg
Tab Piroxicam 20mg
Or Tab Voren /Caflam 50mg 1 tablet TDS Rs.10/13
Tab Diclofenac Atcam/xikarapid for 5 days Rs.
sodium/potassium 1 tablet BD
50mg
Tab lornoxicam 8mg
Topical NSAIDS P-cam gel Apply twice
(Piroxicam) Voltral gel/ Diclo gel daily
(Diclofenac)
+92 309 9726054

Learn Best Disease
Management Skills
5/8/2024
Waqas Male 50
Diagnosis:
OSTEOARTHRITIS
OPIOIDS Tab Tono flex p 1 tablet BD Rs.22/17/tab

Tab tramadol + Tab Pantra plus
paracetamol
Calcium and Vitamin D Tab Qalsan -D/Intig- One tablet Rs.220-300
supplements D/Osteocare/avelia daily
PPI Risek/ruling/omega One capsule Rs.20-35/cap
To avoid NSAID 20mg/40mg 30 mins Rs.30-40/cap
induced gastritis : Nexum/Esso before
cap Omeprazole breakfast
Cap esomeprazole
Intra-articular injection Inj k-kort 40mg/ml 0ne time Rs.150/inj
Intra-articular Rs.350/inj
steroid/Hyaluronic acid
injections can provide
temporary pain relief
PRESCRIPTION:
Tab Caflam 50mg

1+1
‫درد کی صورت میں‬
P-cam gel
‫صبح شام گھٹنے کی مالش کریں‬
Cap Ruling 40mg
‫ناشتے سے آدھا گھنٹہ پہلے‬
Tab Osteocare
‫ دن‬15 ‫ایک گولی روزانہ‬
+92 309 9726054


Osteoarthritis

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Osteoarthritis

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Dr.

Ahmad SYAN OPD HUB

+92 309 9726054

+92 309 9726054

+92 309 9726054

a 65-year-old retired teacher, visits her primary care

+92 309 9726054

• Patient presents with pain in the joint, particularly on movements.

Take Vitals (Bp,pulse, temperature, respiratory rate)

+92 309 9726054

Assess the range of motion:

In affected joints, noting any limitations or stiffness.

Evaluation of muscle strength:

+92 309 9726054

Non pharmacological intervention

▪ X-rays spine show reduced disc space.

Salt Brand Dose Price

+92 309 9726054

OPIOIDS Tab Tono flex p 1 tablet BD Rs.22/17/tab

Tab Caflam 50mg

+92 309 9726054

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