Joint Pain & Osteoarthritis
Also known as: OA, Degenerative Joint Disease
The most common form of arthritis, caused by cartilage breakdown in joints. Managed with targeted injections, weight management, and distinguishing it from inflammatory disease.
Key Facts
- Affects over 32 million American adults — the most common form of arthritis
- Not primarily an autoimmune disease, though inflammation plays a role
- Risk factors include age, obesity, joint injury, and repetitive stress
- Distinguishing OA from inflammatory arthritis is critical — treatments differ fundamentally
- Weight loss of 10-15 pounds can significantly reduce knee pain
What is osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis, affecting millions of adults. It results from the gradual breakdown of cartilage — the protective tissue covering the ends of bones in a joint. Unlike rheumatoid arthritis or psoriatic arthritis, OA is not primarily an autoimmune disease, though inflammation plays a role in its progression.
OA most commonly affects the knees, hips, hands, and spine. It’s a leading reason patients are referred to rheumatology — often to determine whether their joint pain is “just arthritis” or something requiring more aggressive treatment.
A critical part of our role is distinguishing OA from inflammatory arthritis. The treatments are fundamentally different, and misdiagnosis in either direction leads to either unnecessary immunosuppression or undertreated autoimmune disease.
Symptoms
- Joint pain that worsens with activity and improves with rest
- Stiffness after inactivity, typically lasting less than 30 minutes
- Reduced range of motion
- Crepitus — grinding or crackling sensation in the joint
- Joint enlargement, particularly in the fingers (Heberden's and Bouchard's nodes)
- Pain often in weight-bearing joints: knees, hips, lower back
How we diagnose it
- Clinical exam — Joint tenderness, bony enlargement, limited motion, absence of inflammatory signs
- X-rays — Joint space narrowing, bone spurs (osteophytes), subchondral sclerosis
- Musculoskeletal ultrasound — To evaluate for effusion, synovitis, and to rule out coexisting inflammatory arthritis
- Blood work — Primarily to exclude inflammatory conditions (inflammatory markers, RF, anti-CCP are typically normal in OA)
How we treat it
- Ultrasound-guided corticosteroid injections — Precise, image-guided injections for knee, hip, shoulder, and hand OA
- Hyaluronic acid injections — Viscosupplementation available for knee OA
- Weight management — Reducing mechanical load on joints; our obesity medicine program can help
- Physical therapy referral — Strengthening and range-of-motion exercises
- Oral medications — Acetaminophen, topical NSAIDs, oral NSAIDs when appropriate
- Surgical referral — When conservative management fails, referral for joint replacement evaluation
At Synergy Rheumatology
We see many patients referred for "arthritis" who need accurate diagnosis first. Ultrasound helps us distinguish OA from inflammatory conditions on the spot. For OA that needs injection therapy, ultrasound guidance improves accuracy — particularly for hips and thumb base joints where landmark-based injection is unreliable.
Have questions about joint pain & osteoarthritis?
Schedule an appointment to discuss your symptoms, diagnosis, or treatment options with Dr. Fellows.