Diagnosis is made with reasonable certainty based on history and clinical examination. X-rays may confirm the diagnosis. The typical changes seen on X-ray include: joint space narrowing, subchondral sclerosis (increased bone formation around the joint), subchondral cyst formation, and osteophytes. Plain films may not correlate with the findings on physical examination or with the degree of pain. Usually other imaging techniques are not necessary to clinically diagnose osteoarthritis. In 1990, the American College of Rheumatology, using data from a multi-center study, developed a set of criteria for the diagnosis of hand osteoarthritis based on hard tissue enlargement and swelling of certain joints. These criteria were found to be 92% sensitive and 98% specific for hand osteoarthritis versus other entities such as rheumatoid arthritis and spondyloarthropathies. Image:Osteo of the hand.Severe osteoarthritis and osteopenia of the carpal joint and 1st carpometacarpal joint. Image:Gonarthrose-Knorpelaufbrauch.MRI of osteoarthritis in the knee, with characteristic narrowing of the joint space. Image:Osteoarthritis left knee.Primary osteoarthritis of the left knee. Note the osteophytes, narrowing of the joint space (arrow), and increased subchondral bone density (arrow). Image:Damaged cartilage Danish sow.Damaged cartilage from sows. (a) cartilage erosion (b)cartilage ulceration (c)cartilage repair (d)osteophyte (bone spur) formation. Image:Primary osteoarthrosis (2) at knee joint.Histopathology of osteoarthrosis of a knee joint in an elderly female. Image:Primary osteoarthrosis (5) at knee joint.Histopathology of osteoarthrosis of a knee joint in an elderly female. Image:Health joint.In a healthy joint, the ends of bones are encased in smooth cartilage. Together, they are protected by a joint capsule lined with a synovial membrane that produces synovial fluid. The capsule and fluid protect the cartilage, muscles, and connective tissues. Image:Joint with severe osteoathritis.With osteoarthritis, the cartilage becomes worn away. Spurs grow out from the edge of the bone, and synovial fluid increases. Altogether, the joint feels stiff and sore. File:Osteoarthritis.Osteoarthritis File:Osteoarthritis_--_Smart-Servier_(cropped).Bone (left) and clinical (right) changes of the hand in osteoarthritis Classification A number of classification systems are used for gradation of osteoarthritis: * WOMAC scale, taking into account pain, stiffness and functional limitation. * Kellgren-Lawrence grading scale for osteoarthritis of the knee. It uses only projectional radiography features. * Tönnis classification for osteoarthritis of the hip joint, also using only projectional radiography features. * Osteoarthritis can be classified into either primary or secondary depending on whether or not there is an identifiable underlying cause. X-ray of erosive osteoarthritis of the fingers, also zooming in on two joints with the typical "gull-wing" appearance. Both primary generalized nodal osteoarthritis and erosive osteoarthritis (EOA, also called inflammatory osteoarthritis) are sub-sets of primary osteoarthritis. EOA is a much less common, and more aggressive inflammatory form of osteoarthritis which often affects the distal interphalangeal joints of the hand and has characteristic articular erosive changes on x-ray. Osteoarthritis can be classified by the joint affected: * Hand: * Trapeziometacarpal osteoarthritis * Wrist (wrist osteoarthritis) * Vertebral column (spondylosis) * Facet joint arthrosis * Hip osteoarthritis * Knee osteoarthritis
complications of Avascular necrosis
complications of Gangrene
complications of Burn
complications of Vasculitis
complications of Bunion
complications of Raynaud syndrome
complications of Frostbite
medical cause of Edema