− | *H&P: Older patients; polyarticular arthritis in the DIP (Heberden), PIP (Bouchard), 1st CMC, elbow, hip, knee, and back; Morning stiffness lasts < 30 min, but pain worsens with activity as the day progresses. | + | *H&P: Older patients; polyarticular arthritis in the DIP (Heberden), PIP (Bouchard), 1st CMC, elbow, hip, knee, and back; Morning stiffness lasts < 30 min, but pain worsens with activity as the day progresses; can be secondary to trauma or metabolic disease (Wilson or Hemochromatosis) |
| *Dx: Xrays and clinical findings asymmetric joint sclerosis, narrowing, periarticular bone spurs; inflammatory lab markers are normal; joint aspiration has WBCs < 2000 | | *Dx: Xrays and clinical findings asymmetric joint sclerosis, narrowing, periarticular bone spurs; inflammatory lab markers are normal; joint aspiration has WBCs < 2000 |
| *Tx: Exercise, PT, weight loss; NSAIDs, APAP; Glucocorticoid injections; Joint replacement. | | *Tx: Exercise, PT, weight loss; NSAIDs, APAP; Glucocorticoid injections; Joint replacement. |