Alright, so let's talk about how we're
gonna treat patients with osteoarthritis.
Weight loss is important.
Folks who have terrible
knee and hip arthritis,
losing weight will help and prevent
future progression of disease.
Likewise, while our patients are oftentimes
resistant, physical therapy is paramount,
especially aqua therapy which can be a little
bit easier for patients to move around with.
Activity modification can be helpful if there's
particular things that are exacerbating their arthritis.
Sometimes, splinting can be helpful and
immobilization under extreme circumstances.
Ice and heat can provide
some analgesic benefit.
NSAIDs of course, ideally especially in elderly
patients who wanna try topical NSAIDs like diclofenac
and then under some circumstances, especially
if there's some evidence of acute synovitis,
you can do a steroid injection as well though
don't get carried away with doing those too often.
Sometimes, chondroitin sulfate is used.
However, I will say the evidence
and support of that is scant at best.
And lastly, if a person has become
debilitated by their osteoarthritis
especially if it involves
the hip or the knees,
joint replacement surgery
is absolutely an option.
Alright, so taking a look at our first case, who
have the acute-on-chronic osteoarthritic knee pain,
this person, we probably
best treat them with NSAIDs.
Maybe some ice, activity
modification and physical therapy
to strengthen the muscles
and ligaments around that knee.
With an active synovitis, again, you
can consider intra-articular steroids
but I wouldn't do it too often.
And then for our 2nd case, who have
the acute-on-chronic carpometacarpal joint,
also called basal joint arthritis.
I'd also go with the topical
NSAID, maybe some ice,
perhaps a wrist splint temporarily
or at least while working at her job
and again, you could consider a low
dose intra-articular steroid injection.