University of Georgia College of Public Health, Athens, GA, USA.
Am Fam Physician. 2018 Apr 15;97(8):523-526.
Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography can confirm the diagnosis and may be helpful before surgical referral, but findings generally do not correlate well with symptoms. Exercise, physical therapy, knee taping, and tai chi are beneficial for knee OA. Medical therapy provides modest benefits in pain reduction and functional improvement; however, nonsteroidal anti-inflammatory drugs, tramadol, and other opioids have significant potential harms. Joint replacement may be considered for patients with moderate to severe pain and radiographically confirmed OA. Corticosteroid injections may be helpful in the short term. Vitamin D supplements, shoes specifically designed for persons with OA, antioxidant supplements, physical therapy for hip OA, ionized wrist bracelets, lateral wedge insoles for medial knee OA, and hyaluronic acid injections are not effective.
骨关节炎（OA）应怀疑在患者的手指疼痛，肩膀，臀部，膝盖或脚踝，尤其是如果他们超过 40 岁。患者年龄超过 50 岁，有关节疼痛，最小的早晨僵硬和功能障碍可能有 OA。放射学检查可以确认诊断，并可能有助于手术转诊前，但调查结果通常与症状不相符。运动，物理疗法，膝关节贴扎，和太极拳对膝骨关节炎有益。药物治疗在减轻疼痛和改善功能方面提供适度的益处；然而，非甾体抗炎药，曲马多和其他阿片类药物有显著的潜在危害。关节置换术可考虑用于有中度至重度疼痛和影像学证实的 OA 的患者。皮质类固醇注射可能有帮助在短期内。维生素 D 补充剂，专门为 OA 患者设计的鞋子，抗氧化剂补充剂，髋关节的物理疗法，离子腕带，内侧膝骨关节炎的外侧楔形鞋垫，和透明质酸注射都没有效果。
