II. Epidemiology

  1. Most common form of Arthritis
  2. Associated functional Impairment increases with age
  3. Prevalence directly increases with age
    1. Age over 40 years: 70% of U.S. population
    2. Age over 65 years: 80% of U.S. population
    3. See Rheumatologic Conditions in the Elderly

III. Pathophysiology

  1. Primary lesion resides in the articular cartilage
    1. Abnormal cartilage repair and remodeling
    2. Chondrocytes produce proteolytic enzymes
    3. Proteolytic enzymes destroy cartilage
  2. End result
    1. Asymmetric joint cartilage loss
    2. Subchondral sclerosis (bone density increased)
    3. Subchondral cysts
    4. Marginal osteophytes

IV. Risk Factors

  1. Age over 50 years old
  2. Female gender
  3. Obesity
  4. Prior joint injury
  5. Job duties with frequent squatting or bending
  6. Osteoarthritis Family History
  7. Repetitive-impact sports (e.g. soccer, football)

V. Etiologies

  1. Primary
    1. Weight bearing joints
      1. Hands
      2. Hips, Knees, and feet
    2. Stressors
      1. Obesity (single most important factor)
      2. Overuse injuries
  2. Secondary
    1. Acute or Chronic Trauma
    2. History of knee meniscectomy
    3. Congenital abnormalities
    4. Rheumatic Conditions
      1. Gouty Arthritis
      2. Rheumatoid Arthritis
      3. Calcium pyrophosphate deposition disease (CPPD)
    5. Endocrine Conditions
      1. Diabetes Mellitus
      2. Acromegaly

VI. Symptoms

  1. Pain worse later in the day, and better with rest
    1. Pain on motion that worsens with increasing joint usage (gelling)
    2. If morning stiffness is present, is of short duration (<30 minutes)
      1. Contrast with Rheumatoid Arthritis which has morning stiffness >30 minutes
  2. Slowly progressive deformity and variably painful
    1. Initial high-use Joint Pain relieved with rest
    2. Next, pain is constant on affected joint usage
    3. Eventually pain occurs at rest and at night
  3. No systemic manifestations
    1. No Fatigue
    2. No generalized weakness
  4. Associated Muscle spasm, contractures and atrophy
  5. Symptoms uncommon before age 40 years old
  6. Asymmetric involvement

VII. Signs

  1. Joint Exam
    1. Joint Effusion
    2. Atrophy
    3. Joint instability
    4. Joint tenderness
    5. Crepitation
    6. Limited range of motion
  2. Joints spared (Contrast with Rheumatoid Arthritis)
    1. Wrist spared
    2. Metacarpal-phalangeal joints spared (except thumb)
    3. Elbow spared
    4. Ankle spared (variable involvement)
  3. Joints commonly involved
    1. See Shoulder Osteoarthritis
    2. See Acromioclavicular Osteoarthritis
    3. See Knee Osteoarthritis
    4. See Hip Osteoarthritis
    5. See Foot Osteoarthritis
    6. See Hand Osteoarthritis
      1. Distal interphalangeal joints (Heberden's Nodes)
      2. Proximal interphalangeal joints (Bouchard's Nodes)
      3. First carpometacarpal joint (thumb)
    7. Cervical and Lumbar Spine
      1. Mechanisms
        1. Apophyseal joint Arthritis and Osteophytes
        2. Disc degeneration
      2. Secondary affects
        1. Local Muscle spasm
        2. Nerve root impingement with radiculopathy
        3. Cervical stenosis
        4. Lumbar Stenosis (Pseudoclaudication)

VIII. Labs: General (if indicated)

  1. Routine labs are not indicated in typical Osteoarthritis
    1. Obtain for unclear diagnosis
    2. Abnormal results suggest alternative diagnosis
  2. Erythrocyte Sedimentation Rate normal
  3. C-Reactive Protein normal
  4. Rheumatoid Factor negative
  5. Uric Acid normal

IX. Labs: Synovial Fluid (if indicated)

  1. Synovial Fluid appearance
    1. Clear fluid
    2. High viscosity and good mucin
  2. Synovial Fluid Crystals
    1. Basic Calcium Phosphate (BCP) Crystals
    2. Apatite crystals
  3. Synovial Fluid White Blood Cell Count
    1. Non-Inflammatory fluid: 200 - 2000 WBC/mm3
    2. WBC Count usually <500 cells (mostly mononuclear)

XII. Imaging

  1. Imaging is not required for Osteoarthritis diagnosis in patients with typical presentations
    1. XRay, MRI Imaging often does not correlate with Osteoarthritis severity and patient function
      1. Kim (2015) BMJ 351:h5983 +PMID:26631296 [PubMed]
  2. Imaging indicated for pre-operative evaluation or if other diagnosis considered
    1. Joint Trauma
    2. Joint Pain at night
    3. Progressive Joint Pain
    4. Family History of other arthritic conditions
    5. Age under 18 years
  3. Findings
    1. See Osteoarthritis XRay
    2. See Foot XRay in Osteoarthritis
    3. See Hand XRay in Osteoarthritis
    4. See Hip XRay in Osteoarthritis
    5. See Knee XRay in Osteoarthritis
    6. See Spine XRay in Osteoarthritis

XIII. Management: Non-Pharmacologic Treatment

  1. See Knee Osteoarthritis for Muscle Strengthening
  2. Reduce Obesity
    1. Weight loss of 5% from baseline or 6 kg (13 pounds) decreases pain and Disability
  3. Physical Therapy
  4. Physiotherapy (Heat, Cold, Contrast Baths or Ultrasound)
    1. TENS not found to be effective
  5. Consider comorbidity
    1. See Depression in the Elderly
  6. Exercise Program (do not exacerbate symptoms)
    1. Stretching
    2. Mild aerobic, active, Isometric Exercise (eliptical trainer, Bicycle)
    3. Swimming
      1. Highly effective Exercise for strength, flexibility and aerobic fitness
    4. Tai chi
      1. Song (2003) J Rheumatol 30:2039-44 [PubMed]
  7. Joint protection
  8. Work and home modified in severe disease
    1. Limit weight bearing on affected joints
    2. Walk Aids (Canes and Walkers)
  9. Surgery
    1. Hip replacement or knee replacement in refractory cases

XIV. Management: Pharmacologic Management

  1. Acetaminophen (Tylenol) 1 gram orally twice daily (limit to 2-3 grams daily)
    1. Less effective than NSAIDs, but safer
  2. NSAIDs
    1. Cautious use in age over 65 years, prior GI Bleed, Aspirin, Plavix, Warfarin or Corticosteroid
      1. Consider with Proton Pump Inhibitor if 1-2 GI risks
      2. Avoid NSAIDs completely if 3 or more GI risks
    2. Avoid Feldene - higher risk of GI toxicity
    3. Naproxen may have less cardiovascular risks
    4. Observe for CNS effects (esp. Indomethacin)
    5. Consider topical diclofenac (see below)
    6. Switch classes when one NSAID is not effective
      1. Diclofenac (Voltaren) 50 mg two to three times daily
      2. NaproxenSodium (Naprosyn) 500 mg orally twice daily
      3. Ibuprofen (Advil) 600 mg three times daily
      4. Meloxicam (Mobic) 15 mg daily
      5. Nabumetone (Relafen) 500 mg twice daily
      6. Sulindac (Clinoril) 200 mg twice daily
  3. COX2 Inhibitors
    1. Celecoxib (Celebrex) 200 mg daily
    2. No advantages to standard NSAIDs and still very expensive
  4. Topical agents
    1. Topical diclofenac
      1. May be as effective as oral NSAIDs if only a few joints involved
      2. Expensive and risk of skin reaction
    2. Topical Capsaicin cream
      1. Effective for refractory Joint Pain
      2. Poorly tolerated
    3. Avoid topical Salicylates such as Bengay (ineffective for Osteoarthritis)
  5. Intraarticular agents
    1. Intra-articular Corticosteroid injection
      1. Avoid more than 3-4 times per year
    2. Sodium hyaluronate (Synvisc) in Knee Osteoarthritis
  6. Other systemic Analgesics
    1. Tramadol (Ultram)
      1. Effective, but with risks (NNT 6, NNH 8)
      2. Cepeda (2007) J Rheumatol 34(3): 543-55 [PubMed]
    2. Duloxetine (Cymbalta)
      1. Effective, but with moderate Nausea risk (NNT 7, NNH 6)
      2. Citrome (2012) Postgrad Med 124(1): 83-93 [PubMed]
    3. Opioids
      1. Generally not recommended due to significant risks

XV. Management: Alternative Medications

  1. Possibly effective agents (insufficient evidence to recommend)
    1. Dimethyl Sulfoxide (DMSO) 25% applied topically
      1. Small, 3 week studies showed reduced pain
    2. Devil's Claw 2.4 grams daily
    3. Ginger Extract 510 mg daily
    4. Methlsulfonylmethane (MSM) 500 mg three times daily
    5. S-Adenosylmethionine (SAMe) 200 mg three times daily
      1. Methyl donor in proteoglycan synthesis
      2. More effective than Placebo for pain, stiffness
      3. Very expensive and unstable shelf life (Butanedisulfonate salt is most stable)
    6. Glucosamine Sulfate
      1. Dosing 1500 mg once daily or 500 mg orally three times daily
      2. Effect may be delayed for 2 months
      3. Initial studies demonstrated benefit
        1. Towheed (2005) Cochrane Database Syst Rev (2):CD002946 [PubMed]
        2. Richy (2003) Arch Intern Med 163(13):1514-22 [PubMed]
      4. Later studies show no significant benefit
        1. Roman-blas (2017) Arthritis Rheumatol 69(1): 77-85 [PubMed]
        2. Wilkins (2010) JAMA 304(1):45-52 [PubMed]
  2. Unknown benefit (anecdotal, inconclusive data or only small studies support)
    1. Avocado-soybean unsaponifiables 300 mg daily
    2. Boron supplementation
      1. Effects Calcium Metabolism in bones, joints
      2. Higher Arthritis rates with low boron intake
    3. Cetyl Myristoleate (anti-inflammatory effects)
    4. Acupuncture
    5. FLUIDjoint
      1. Concentrated milk Proteins from New Zealand
      2. Promoted as containing antibodies for Immunity
      3. Not recommended due to $50/month and unproven
  3. Agents to avoid
    1. Agents that are ineffective for Osteoarthritis (but may have other indications)
      1. Vitamin D Supplementation
      2. Antioxidant supplements
    2. Ineffective agents (avoid these based on high quality studies)
      1. Chondroitin sulfate 400 mg orally three times daily
      2. Tipi
      3. Reumalex
      4. Ionized wrist bracelets
      5. Osteoarthritis Shoes
    3. Preparations with serious adverse effects and either ineffective or unproven efficacy
      1. Limbrel (Flavocoxid)
        1. Risk of Acute Hepatitis and Hypersensitivity pneumonitis
  4. References
    1. Morelli (2003) Am Fam Physician 67(2):339-44 [PubMed]
    2. Gregory (2008) Am Fam Physician 77(2): 177-84 [PubMed]

XVI. Prevention

  1. Maintain appropriate body weight
  2. Continued moderate joint activity is critical
    1. Normal joint use directs cartilage remodeling
    2. Decreased joint use risks abnormal cartilage repair

XVII. Resources: Patient Education

  1. Information from your Family Doctor: Staying Active
    1. http://www.familydoctor.org/healthfacts/115/

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Arthropathy (C0022408)

Definition (MEDLINEPLUS)

A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including

  • Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, the joint can become severely damaged.
  • Bursitis - inflammation of a fluid-filled sac that cushions the joint
  • Dislocations - injuries that force the ends of the bones out of position

Treatment of joint problems depends on the cause. If you have a sports injury, treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery. For arthritis, injuries, or other diseases, you may need joint replacement surgery to remove the damaged joint and put in a new one.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Definition (NCI) Any disorder of the joints.
Definition (CSP) condition in which there is a deviation from or interruption of the normal structure or function of the joints.
Concepts Disease or Syndrome (T047)
MSH D007592
ICD9 716.90, 719.90, 716.9, 719.9
ICD10 M15-M19.9 , M19.9, M25.9, M00-M25.9, M19.90, M12.9, M25.98, M25.99
SnomedCT 227588009, 8316001, 156514009, 267904003, 202073005, 202635007, 268051001, 202634006, 202061005, 203747002, 268056006, 202647001, 156508002, 268070006, 202645009, 80843008, 267888004, 202059001, 156616003, 399269003, 396275006
English Disease, Joint, Diseases, Joint, Joint Diseases, Arthropathy, unspecified, Unspecified disorder of joint, ARTHROSIS, ARTHROPATHY, JOINT DYSFUNCTION, Joint Disease, joint disorder, Arthropathy, unspecified, site unspecified, Unspecified disorder of joint, site unspecified, [X]Arthrosis, Arthropathies NOS, Arthropathy NOS, Arthropathy NOS, of unspecified site, Arthropathy NOS-site unspecif., Arthrosis, unspecified, Joint disord.NOS-site unspecif, Joint disorder NOS, of unspecified site, Joint disorder, unspecified, Joint disorders NOS, JOINT DIS, arthropathic, Arthropathy, arthropathy, arthropathy (diagnosis), Arthropathies, Arthropathy (NOS), Unspecified arthropathy, Arthrosis NOS, Disorder joint, Joint disorder NOS, Joint dysfunction, Arthropathy NOS-unspec, Joint dis NOS-unspec jt, Joint Diseases [Disease/Finding], Unspecified joint disorder, other site, Unspecified joint disorder, site unspecified, Unspecified joint disorder, Dysfunction;joint, arthropathy nos, articular disease, diseases of joints, joint disorders, joint diseases, arthropathies, joint disease, diseases of the joints, Joint disorders, joint disorder (diagnosis), Joint Disorders, Osteoarthrosis (disorder), Arthropathy NOS (disorder), Arthropathy NOS, of unspecified site (disorder), Joint disorders NOS (disorder), Joint disorder NOS, of unspecified site (disorder), Arthropathies NOS (disorder), [X]Arthrosis (disorder), Joints--Diseases, DISORDER, JOINT, JOINT DISORDER, Joint disease, Osteoarthrosis, Arthrosis, Joint disorder, Disorder of joint, Arthropathy (disorder), arthrosis, disease (or disorder); joint, joint; disorder, joint; osteoarthrosis, osteoarthrosis; joint, Arthropathy, NOS, Arthrosis, NOS, Disorder of joint, NOS, Joint disease, NOS, Osteoarthrosis, NOS, Joint Disorder, joint dysfunction
French ARTHROSE, Arthrose SAI, Trouble articulaire non précisé, site non précisé, Arthropathie non précisée, Arthrose, Trouble articulaire, Arthropathie SAI, Atteintes articulaires diverses SAI, Dysfonction articulaire, Trouble articulaire non précisé, Arthropathie non précisée, site non précisé, ARTHROPATHIE, DYSFONCTIONNEMENT ARTICULAIRE, Affections articulaires, Arthropathie, Troubles des articulations, Arthropathies, Maladies articulaires, Maladies de l'articulation, Maladies des articulations
Italian Artropatia, Patologie articolari, Patologia dell'articolazione, Patologia articolare, Patologia articolare NAS, Artropatia (NAS), Artropatia non specificata, Artrosi, Artropatia non specificata, sede non specificata, Disturbi articolari non specificati, Disturbi articolari non specificati, sede non specificata, Artropatia NAS, Artrosi NAS, Disfunzione articolare, Malattie articolari
Dutch artrose, gewrichtsaandoening, gewrichtsdisfunctie, niet-gespecificeerde gewrichtsaandoening, gewrichtsaandoening NAO, artrose NAO, niet-gespecificeerde gewrichtsaandoening, plaats niet-gespecificeerd, artropathie NAO, niet-gespecificeerde artropathie, artropathie (NAO), niet-gespecificeerde artropathie, plaats niet-gespecificeerd, aandoening gewricht, aandoening; gewricht, gewricht; aandoening, gewricht; osteoartrose, osteoartrose; gewricht, Artrose, niet gespecificeerd, Gewrichtsaandoening, niet gespecificeerd, artropathie, gewrichtsaandoeningen, Gewrichtsziekte, Gewrichtsziekten, Ziekte, gewrichts-, Ziekten, gewrichts-
German Arthropathie (NNB), Arthropathie, unspezifisch, Erkrankung Gelenk, unspezifische Arthropathie, unspezifische Gelenkerkrankung, Arthrosis NNB, Arthropathie NNB, Gelenkerkrankung, Gelenkaffektion NNB, Gelenkfunktionsstoerung, unspezifische Gelenkerkrankung, Stelle unspezifisch, Arthropathie, unspezifisch, Stelle unspezifisch, Arthrose, ARTHROPATHIE, ARTHROSE, Arthrose, nicht naeher bezeichnet, GELENKFEHLFUNKTION, Gelenkkrankheit, nicht naeher bezeichnet, Arthropathie, Gelenkerkrankungen, Gelenkkrankheiten
Portuguese Artrose NE, Disfunção articular, Afecção articular NE de localização NE, Artropatia NE, Afecção articular NE, Artropatia NE de localização NE, Afecção articular, Artrose, ARTROPATIA, ARTROSE, DISFUNCAO ARTICULAR, Afecções das articulações, Artropatia, Artropatias
Spanish Artropatía NEOM, Disfunción articular, Artropatía no especificada, Trastorno articular no especificado, localización no especificada, Artropatía (NEOM), Artropatía no especificada, localización no especificada, Trastorno de articulación, Trastorno articular NEOM, Trastorno articular no especificado, Artrosis NEOM, Artrosis, Trastorno articular, ARTICULACION, DISFUNCION, ARTROPATIA, ARTROSIS, artropatía, SAI, de sitio no especificado (trastorno), artropatía, SAI (trastorno), trastornos articulares, SAI, trastornos articulares, SAI (trastorno), enfermedad articular, artrosis, SAI, de sitio no especificado (trastorno), Joint disorders NOS, artropatía, SAI, artropatía, SAI, de sitio no especificado, trastorno articular, SAI, de sitio no especificado, trastorno articular, [X]artrosis, [X]artrosis (trastorno), artropatías, SAI (trastorno), Arthropathy NOS, artropatías, SAI, artrosis, SAI, de sitio no especificado, trastorno articular, SAI, de sitio no especificado (trastorno), artrosis, SAI (trastorno), artrosis, SAI, artropatía (trastorno), artropatía, Trastornos articulares, Artropatía, Artropatías
Japanese 関節障害(NOS), 関節症, 関節障害NOS, 詳細不明の関節障害、部位不明, 詳細不明の関節障害, 部位および詳細不明の関節障害, 関節症NOS, 関節機能不全, 関節障害, カンセツショウガイ, カンセツショウ, カンセツショウガイNOS, ショウサイフメイノカンセツショウガイブイフメイ, カンセツショウNOS, ブイオヨビショウサイフメイノカンセツショウガイ, カンセツキノウフゼン, ショウサイフメイノカンセツショウガイ
Swedish Ledsjukdomar
Finnish Nivelsairaudet
Czech Artropatie NOS, Artróza, Artropatie, Artróza NOS, Artropatie, blíže neurčená, Porucha kloubu, Porucha kloubu, blíže neurčená, Kloubní poruchy, Artropatie blíže neurčená, blíže neurčené lokalizace, Kloubní porucha, Dysfunkce kloubu, Porucha kloubu, blíže neurčená, blíže neurčené lokalizace, Kloubní porucha NOS, nemoci kloubů, klouby - nemoci
Korean 상세불명의 관절 장애, 상세불명의 관절증
Polish Choroby stawów
Hungarian Arthropathia (k.m.n.), Ízületi betegség, Arthropathia, Ízület nem meghatározott betegsége, hely nem meghatározott, Arthropathia, nem meghatározott, Ízületi betegség k.m.n., Ízület működési zavara, Nem meghatározott arthropathia, Arthropathia k.m.n., Ízület nem meghatározott betegsége, Arthropathia, nem meghatározott, hely nem meghatározott, Ízületi betegségek, Arthrosis, Arthrosis, k.m.n.
Norwegian Leddsykdommer, Sykdommer i leddene

Ontology: Degenerative polyarthritis (C0029408)

Definition (MEDLINEPLUS)

Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in your joints. It can occur in any joint, but usually it affects your hands, knees, hips or spine.

Osteoarthritis breaks down the cartilage in your joints. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage absorbs the shock of movement. When you lose cartilage, your bones rub together. Over time, this rubbing can permanently damage the joint.

Risk factors for osteoarthritis include

  • Being overweight
  • Getting older
  • Injuring a joint

No single test can diagnose osteoarthritis. Most doctors use several methods, including medical history, a physical exam, x-rays, or lab tests.

Treatments include exercise, medicines, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Definition (NCI) A noninflammatory degenerative joint disease occurring chiefly in older persons, characterised by degeneration of the articular cartilage, hypertrophy of bone at the margins and changes in the synovial membrane. It is accompanied by pain and stiffness, particularly after prolonged activity.(On-line Medical Dictionary)
Definition (MSH) A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans.
Definition (CSP) noninflammatory degenerative joint disease occurring chiefly in older persons, characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins, and changes in the synovial membrane, accompanied by pain and stiffness.
Concepts Disease or Syndrome (T047)
MSH D010003
ICD9 715.9
ICD10 M19.90 , M19.9, M15-M19
SnomedCT 396275006, 80843008, 156486003, 267888004, 224729007, 201886002, 227588009, 267893001, 226586002, 201818008, 156496007, 201887006, 201917002, 225655006
LNC LA17768-5
English Arthritides, Degenerative, Arthritis, Degenerative, Degenerative Arthritides, Osteoarthritides, Osteoarthritis, Osteoarthroses, Osteoarthrosis, Osteoarthrosis, unspecified whether generalized or localized, Degenerative Arthritis, OSTEOARTHRITIS, Osteoarthritis NOS, Osteoarthritis NOS, of unspecified site, Osteoarthritis NOS-site unspec, hypertrophic arthritis, OA, OSTEOARTHROSIS, degenerative arthritis, DJD, osteoarthrosis, degenerative joint disease, osteoarthritis, osteoarthrosis (diagnosis), osteoarthritis (diagnosis), OS1, OSTEOARTHRITIS OF HIP, FEMALE-SPECIFIC, SUSCEPTIBILITY TO, OSTEOARTHRITIS SUSCEPTIBILITY 1, Osteoarthritis, unspecified site, Osteoarthritis [Disease/Finding], O/A, arthritis degenerative, degenerative disease joints, Arthritis;degenerative, osteoarthritis degenerative, Osteoarthritis;degenerative, a o, arthrosis, degenerative disease joint, degenerative diseases joint, oas, osteoarthritis arthritis, arthritis osteoarthritis, degenerative arthropathy, oa osteoarthritis, o a, Osteoarthritis (M15-M19), Degenerative Joint Disease, Degenerative joint disease (disorder), Joint degeneration, Degenerative arthropathy (disorder), Osteoarthritis NOS (disorder), Osteoarthritis (& [allied disorders]), [Joint degeneration] or [osteoarthritis NOS] (disorder), Osteoarthritis NOS, of unspecified site (disorder), Osteoarthritis and allied disorders, [Joint degeneration] or [osteoarthritis NOS], Degenerative arthropathy, Degenerative arthritis, Hypertrophic arthritis, Degenerative joint disease, OA - Osteoarthritis, OA - Osteoarthrosis, Degenerative polyarthritis (disorder), Hypertrophic polyarthritis, Osteoarthritis (disorder), Degenerative polyarthritis, hypertrophy; arthritis, arthritis; hypertrophy, Degenerative arthritis, NOS, Degenerative arthropathy, NOS, Degenerative joint disease, NOS, Degenerative polyarthritis, NOS, Hypertrophic arthritis, NOS, Hypertrophic polyarthritis, NOS, Osteoarthritis, NOS, degenerative osteoarthritis, joint(s) degeneration, Degeneration;joint(s)
Spanish artrosis (trastorno), artrosis, enfermedad articular degenerativa, Osteoartritis NEOM, Enfermedad articular degenerativa, Osteoartrosis, no especificada como generalizada o localizada, OA, artropatía degenerativa, artrosis, SAI (trastorno), artrosis, SAI, Osteoarthritis NOS, artropatía degenerativa (trastorno), artritis degenerativa, osteopatía degenerativa, osteoartrosis, Artrosis, OA - Osteoartritis, OA - Osteoartrosis, osteoartritis (trastorno), osteoartritis, poliartritis degenerativa (trastorno), poliartritis degenerativa, Osteoartritis, Osteoartrosis, Artritis Degenerativa
Dutch osteoartritis NAO, osteoartrose, degeneratieve gewrichtsaandoening, osteoatrose, niet-gespecificeerd als gegeneraliseerd of gelokaliseerd, artritis; hypertrofie, hypertrofie; artritis, osteoartritis, Artritis, degeneratieve, Artrose, Osteoartrose
French Arthrose non précisée généralisée ou localisée, Arthrose SAI, OA, A, Ostéoarthrite, Arthrose, Ostéoarthrose
German Osteoarthrosis, unspezifisch ob generalisiert oder lokalisiert, degenerative Gelenkerkrankung, Osteoarthritis NNB, O/A, OA, Osteoarthrosis, Arthrose, Osteoarthrose
Italian Osteoartrite NAS, Artrosi non specificata se generalizzata o localizzata, Malattia articolare degenerativa, Osteoartrosi, Artrite degenerativa, Osteoartrite
Portuguese Osteoartrite NE, Artropatia degenerativa, Osteartrose, Osteartrose NE se generalizada ou localizada, Osteartrite, Artrose, Artrite Degenerativa, Osteoartrite, Osteoartrose
Japanese 汎発性か限局性か不明の骨関節症, 変性関節疾患, ハンパツセイカゲンキョクセイカフメイノコツカンセツショウ, コツカンセツショウ, ヘンセイカンセツシッカン, 骨関節症-変形性, 変形性骨疾患, 関節症-変形性, 骨関節症, 変形性骨関節症, 骨関節炎, 変性関節炎, 変形性関節症NOS, ヘンケイセイカンセツショウ, ヘンケイセイカンセツショウNOS, OA, OA, O/A, 関節炎-変性, 変形性関節症
Swedish Artros
Czech osteoartritida, osteoartróza, Degenerativní onemocnění kloubů, Osteoartritida NOS, Osteoartritida, Osteoartróza, Osteoartróza, blíže neurčená jako generalizovaná nebo lokalizovaná, degenerativní artritida
Finnish Artroosi
Polish Osteoartroza, Choroba zwyrodnieniowa układu kostno-stawowego, Choroba zwyrodnieniowa stawów, Guzki Heberdena, Artroza
Hungarian Arthrosis, nem meghatározott, hogy generalizált vagy lokalizált, Degeneratív ízületi betegség, OA (arthrosis), Arthrosis k.m.n., O/A (arthrosis), Arthrosis
Norwegian Osteoartrose, Degenerativ leddsykdom, Artrose