Osteoarthritis is primarily characterized byprogressive damage to joint cartilageand changes to structures around the joint, causing pain andlimited range of motionin the affected joint. Fluid accumulation (joint effusion), bony overgrowth (osteophytes), and weakness of tendons and muscles can also result from the degenerative process.

Typically, osteoarthritis develops gradually. You'll feel sore or stiff at first. The discomfort may be moderate and not be constantly present. Other signs and symptoms associated with osteoarthritis may include: Joint soreness after inactivity or periods of overuse of a joint Stiffness after rest and disappears quickly as activity begins again Morning stiffnesslasting no longer than 30 minutes Joint pain which is less in the morning and stronger at the end of the day following activity Muscle atrophyaround joints caused by inactivity can increase pain Pain and stiffness can affect posture, coordination and ability to walk Joints of the knees, hips, fingers, lower spine, and neck are most commonly affected by osteoarthritis. The knuckles, wrists, elbows, shoulders and ankles are rarely affected by osteoarthritis except when you injure or overuse the joint Signs ofknee osteoarthritismay include pain exacerbated by moving the knee, knee locking or catching, pain when standing up from a chair, pain when going up and down stairs, and weakening thigh muscles

Lain: Signs ofhip osteoarthritismay include pain in the groin, inner thigh, or buttocks and a pronounced limp. Signs ofknee osteoarthritismay include pain exacerbated by moving the knee, knee locking or catching, pain when standing up from a chair, pain when going up and down stairs, and weakening thigh muscles. Signs ofosteoarthritis of the fingersmay include pain and swelling of the finger joints, the presence ofHeberden's nodesorBouchard's nodes, enlarged joints, and problems with manual dexterity. Signs ofosteoarthritis of the feetmay first be revealed by pain and tenderness in the large joint of the big toe.Certain shoes, such as high heels, can provoke pain in osteoarthritic feet too. Osteoarthritis of the spineoccurs when there is deterioration of spinal discs. The breakdown can causeosteophytes(bone spurs) to develop. The neck and lower back are stiff and painful. Pressure on nerves in the spinal cord can cause pain radiating to the neck, shoulder, arm, lower back, and legs or numbness in arms and legs. Risk factors for osteoarthritis include: overweight, age (usually affecting middle age to older people), injury and genetic predisposition to osteoarthritis.

Penting :Osteoarthritis of the Knee From american collage of rheumatology Kneepain and; At least three of the following 6 criteria: 50 years of age or older, stiffness lasting less than 30 minutes, crepitus, bony tenderness, bony enlargement, no warmth to the touchLaboratory findings which are useful to assessing knee osteoarthritis includesedimentation rateless than 40 mm/hour,rheumatoid factorless than 1:40, and synovial fluid examination showing clear, viscous fluid with a white blood cell count less than 2,000/mm3.It is the doctor's job to be the diagnostician but it clearly is helpful if the patient understands why tests are being performed and what the results mean. If a patient understands the process from early symptoms to diagnosis to treatment plan, the patient will likely be more compliant and the outcome of treatment will likely be more successful.http://osteoarthritis.about.com/od/osteoarthritisdiagnosis/a/OA_diagnosis.htmtreatment : http://arthritis.about.com/lr/osteoarthritis_treatment/59635/4/The goals of osteoarthritis treatment are to relieve pain and other osteoarthritis symptoms, preserve or improve joint function, and reduce physical disability6. Intraarticular Therapies:The judicious use of intra-articular glucocorticoid injections is appropriate for OA patients who cannot tolerate, or whose pain is not well controlled by, oral analgesic and anti-inflammatory agents= kebijakan dalam menggunakan intra-articular glucocortocoid injection jika pasien OA tidak bisa di toleransi, nyeri yang tidak terkontrol oleh analgesi oral dan anti-inflamasi.5. Topical analgesic therapies include topical capsaicin and methyl salicylate creams. There is an FDA approved topical NSAID for the treatment of OA, diclofenac gel, which can be particularly useful for patients who are intolerant to the gastrointestinal side effects of NSAIDs= pemberian topical juga bisa, yaitu topikal capsaisil dan krim metilsalisilat. FDA menerima topical NSAID untuk pengobatan OA yg mana berguna untuk pasien yang tidak toleran terhadap efek samping gastrointestinal dari NSAID.4. Other Oral Analgesic Agents:For patients who cannot tolerate NSAIDs or COX-2 inhibitors other analgesics alone or in combination may be apporrpriate. Tramadol,a non-NSAID/COX2 non-opioid pain medication, can be effective to manage pain symptoms alone or in combination with acetaminophen.Opioids should be a last resort for pain management, often in late-stage disease, given their many side effects including constipation, somnolence, and potential for abuse= untuk pasien yang tidak toleran dengan NSAID atau COX-2 inhibitor, analgesil lain bsa diberikan atau kombinsasi juga bisa. Tramadol (non NSAID/COX-2 inh) non opioid, bsa efektif untuk mengatasi nyeri, baik penggunaan sendiri, atau dikombinasikan dengan asetaminophen malah lebih bagus. Opioid, merupakan opsi terakhir dan digunakan untuk OA dengan stadium akhir.3. Cyclooxygenase-2 (COX-2) inhibitors are a class of NSAIDs) that recently received Food and Drug Administration (FDA) approval. These specific COX-2 inhibitors are effectivefor the pain and inflammation of OA. Their theoretical advantage, however, is that they will cause significantly less toxicity than conventional NSAIDs, particularly in the GI tract. NSAIDs exert their anti-inflammatory effect primarily by inhibiting an enzyme called cyclooxygenase (COX), also known as prostaglandin (PG) synthase. COX catalyzes the conversion of the substrate molecule, arachidonic acid, to prostanoids.= COX-2 inh sudah diterima oleh FDA sebagai obat efektif untuk nyeri dan inflamasi dari OA. Dari teorinya, mempunyai efek samping yg lebih rendah dari pada NSAID yg lain(toxisitas pada GI). COX-2 inh menghambat kerja dari enzim COX dalam pembentukan prostanoid(prostaglandin E, D F2a, prostasiklin dan tromboxan) dari asam arakidonat yang berperan dalam terjadinya rasa nyeri dan anti-inflamasi.2. NSAID.sudah menjadi pilahan sejak lama untuk mengatasi inflamasi dan sebagai analgesik. Mekanisme kerja dengan menghambat kerja dari enzim siklooksigenase dalam pembentukan prostaglandin. Efeksamping yang muncul biasanya berasal dari organ-organ yang membutuhkan prostaglandin dalam homeostasisnya, contohnya labung yang mana membutuhkan prostglandin untuk keseimbangan lapisan lambung. Untuk penggunaan yg non selektif(ibuprofen), harus berhati-hati, biasanya dimulai dengan dosis rendah dan di hubungkan dengan proton pump inhibitor. Pengecekan secra berkala dari renal flow.1. analgesik. Asetaminofen. Pilihan paling utama dalam pengobatan OA. Dengan dosis 4000 mg / hr. Tetapi biasanya pasien meminta obat analgesi yang lebih poten atau NSAID untuk mengontrol sakit.Non farmakologiMengurangi berat badan.Risk factors associated with osteoarthritis include: age obesity injury or overuse of joint heredity/family history muscle weakness

Your doctor will likely recommend one or more of the following treatment options to manage your osteoarthritis symptoms: arthritis medications exercise weight control joint protection techniques complementary or alternative treatments physical therapy/occupational therapy surgery

In older people, meniscal tears can occur after cartilage wears thin and weakens.develop as a reparative response by the remaining cartilage in a damaged joint.=sebagai respon reparatif dari tulang rawan yang tersisa. Jadi, karena ada kerusakan dari tulang rawan, menyebakan terjadinya inkontiunitas pada tulang rawan, selanjutnya tulang rawan yang tersisa akan melakuakn autoreparasi terhadap kartlago yg rusak, hal ini menyebabkan terjadinya penonjolan pada tulang rawan yang tersisa.

Deterioration of articular cartilage is the main problem associated with knee osteoarthritis=kemerosotan dari tulang rawan merupakan problem utama yang tergbung dalam osteoarthritis lutut.The condition can be caused by: (kondisi dapat disebabkan oleh) : previous knee injury = cedera lutut sebelumnya repetitive strain on the knee = peregangan lutut yang berulang fractures, ligament tear, and meniscal injury which can affect alignment and promote wear and tear genetics which make some people more likely to develop knee osteoarthritis=genetik yang membuat beberapa org dapt berkmbang menjadi osteoarthritis. obesity problems with subchondral bone (the bone layer underneath cartilage)

Researchers have analyzed cartilage loss in the knee joint and found that three factors predict it -- medialmeniscaldamage, lateral meniscal damage, andvarus malalignment(bow-legged) of the knee joint.=dari hasil penelitian menganalisis kehilangan kartilago pada sendi lutut dan ditemuakn 3 faktor yang jadi prediksi: Rusak pada meniskus medial, rusak pada meniskus lateral,

Naik 1 unit = kemungknan 11%

The location of the knee pain can be useful information when trying to obtain an accurate diagnosis. Pain on the front of the knee can be caused bybursitis,arthritis, or softening of the patella cartilage, as in chrondromalacia patella.Pain on the side of the knee is usually associated with injury to the collateral ligaments, arthritis, ortears to the menisci. Pain in the back of the knee can be caused by arthritis or aBaker's cyst(an accumulation of synovial fluid behind the knee).Infectionmay be another possible cause of knee pain.