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1

Prescott, Vanessa. A picture of osteoarthritis in Australia. Australian Institute of Health and Welfare, 2007.

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2

Prescott, Vanessa. A picture of osteoarthritis in Australia. Australian Institute of Health and Welfare, 2007.

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3

L, Sutton Amy, ed. Arthritis sourcebook: Basic consumer health information about the risk factors, symptoms, diagnosis, and treatment of osteoarthritis, rheumatoid arthritis, juvenile arthritis, gout, infectious ... 3rd ed. Omnigraphics, 2010.

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4

Doherty, Michael. Osteoarthritis. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0266.

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Osteoarthritis (OA) is a disorder of synovial joints and is characterized by the combination of focal hyaline cartilage loss and accompanying subchondral bone remodelling and marginal new bone formation (osteophyte). It has genetic, constitutional, and environmental risk factors and presents a spectrum of clinical phenotypes and outcomes. OA commonly affects just one region (e.g. knee OA, hip OA). However, multiple hand interphalangeal joint OA, usually accompanied by posterolateral firm swellings (nodes), is a marker for a tendency towards polyarticular ‘generalized nodal OA’.
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5

Abhishek, Abhishek, and Michael Doherty. Epidemiology and risk factors for calcium pyrophosphate deposition. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0048.

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Calcium pyrophosphate crystal deposition (CPPD) is rare in younger adults but becomes increasingly common over the age of 55 years, especially at the knee. Ageing and osteoarthritis (OA) are the main attributable risk factors. Hyperparathyroidism, hypomagnesaemia, haemochromatosis, and hypophosphatasia are other less common risk factors. Rare families with familial CPPD have been reported from many different parts of the world, and mainly present as young-onset polyarticular CPPD. Recent studies suggest that CPPD occurs as the result of a generalized constitutional predisposition and may also
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6

Vincent, Tonia L., and Linda Troeberg. Pathogenesis of osteoarthritis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0138.

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Understanding pathogenic mechanism in disease is critical for development of targeted therapeutic strategies. Although there are, at this time, only a handful of experimental approaches for treating osteoarthritis (OA), until 10 years ago this disease was almost universally considered an unmodifiable condition. Emerging data during this time, largely fuelled by studies in rodent models, has completely changed the paradigm of disease pathogenesis and has for the first time, generated novel, realistic targets for this highly prevalent and disabling condition. These targets include the aggrecanas
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7

Doherty, Michael, Johannes Bijlsma, Nigel Arden, David J. Hunter, and Nicola Dalbeth. Introduction: what is osteoarthritis? Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0001.

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This brief introductory chapter summarizes some of the key clinical and structural features of osteoarthritis (OA) and highlights some general observations and concepts concerning the nature of OA. General observations include the preservation of OA throughout human evolution; the occurrence of OA in many other animals; the dynamic, metabolically active nature of OA pathophysiology; the fact that most OA never associates with symptoms or functional impairment; and the good outcome in many cases of symptomatic OA. Such observations support the concept of OA as the inherent repair process of syn
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8

Doherty, Michael, David J. Hunter, Hans Bijlsma, Nigel Arden, and Nicola Dalbeth, eds. Oxford Textbook of Osteoarthritis and Crystal Arthropathy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.001.0001.

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The Oxford Textbook of Osteoarthritis and Crystal Arthropathy provides full coverage of joint failure, and includes detailed sections on epidemiology, risk factors, clinical assessment, and investigations. There are also new in-depth sections on gout and other crystal arthropathies. Clinically relevant and easily understandable overviews of basic science, including pathology and pain physiology, along with critical appraisal of current guidelines, make this a highly valuable resource. Significant coverage is also given to patient education and the involvement of the patient in management plann
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9

Dekker, Joost, Daniel Bossen, Jasmijn Holla, Mariëtte de Rooij, Cindy Veenhof, and Marike van der Leeden. Psychological strategies in osteoarthritis of the knee or hip. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0025.

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Characteristic clinical presentations of osteoarthritis (OA) include pain and activity limitations. These presentations are dependent on psychological processes. The literature reviewed in this chapter leads to the following conclusions: (1) symptoms of depression, anxiety, and fatigue are more prevalent among patients with OA than among the general population. Recently, a depressive mood phenotype has been identified in knee OA. (2) Symptoms of depression, anxiety, and fatigue, as well as other psychological variables are established risk factors for future worsening of pain and activity limi
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10

Runhaar, Jos, and Sita M. A. Bierma-Zeinstra. Lifestyle. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0012.

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Modern lifestyles put a great burden on the human musculoskeletal system. Since 1980, the worldwide prevalence of obesity has tripled in many European countries. Obesity is known to affect both weight-bearing and non-weight-bearing joints due to a combination of mechanical overload and systemic inflammation. On the other hand, both to combat the obesity pandemic and to increase or maintain the quality of life, physical activity and sports are encouraged next to a healthy diet. Although both have a positive influence on cardiovascular risk factors, physical activity and especially sporting acti
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11

Calisoff, Randy L., and David R. Walega. Chronic Knee Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0010.

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Chronic knee pain affects 27 million people in the United States and is a leading cause of disability. Seventy percent of the population 65 years or older will have knee pain with radiographic evidence of osteoarthritis, and 12% will have clinical symptoms of osteoarthritis. Chronic knee pain after total knee replacement ranges from 10% to 20%. Patellofemoral pain syndrome (PFPS) refers to anterior knee pain exacerbated with knee joint loading activities (squatting, kneeling, prolonged sitting, ascending/descending stairs). PFPS is a clinical diagnosis, and treatment is directed toward pain al
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12

Valdes, Ana M. Genetics. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0009.

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Epidemiological studies have demonstrated that osteoarthritis (OA) is a complex trait with numerous environmental and genetic risk factors. A great deal of effort has been spent elucidating these risk factors and progress has been made. It is clear however that the causes behind OA development and progression continue to remain largely elusive. Identification of those genes that, in conjunction with environmental factors, predispose to OA severity will lead to a better understanding of the mechanisms underlying disease development and thus promote improved health strategies for prevention. An
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13

Roddy, Edward, and Michael Doherty. Calcium pyrophosphate crystal deposition (CPPD). Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0142.

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Calcium pyrophosphate crystal deposition (CPPD) in articular cartilage is a common age-related phenomenon. Recent important advances in our understanding of the pathophysiology of pyrophosphate metabolism include the identification of a mutation within the ANK gene which associates with familial CPPD, and elucidation of the interleukin-1β‎ (IL-1β‎)-dependent mechanisms by which crystals invoke an inflammatory response. Risk factors for CPPD include age, prior joint damage and osteoarthritis, genetic factors, and occasionally metabolic diseases (hyperparathyroidism, haemochromatosis, hypomagnes
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14

Walsh, David A. Contextual aspects of pain: why does the patient hurt? Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0014.

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The context in which osteoarthritis (OA) pain is experienced moderates and, to an extent, mediates its severity and impact. Context is both internal to the patient (e.g. genes, gender, age, comorbidities, psychological distress, and catastrophizing), and a consequence of external factors (e.g. social, healthcare, and work environment). Context influences how people report their pain, and also how the nervous system processes nociceptive information. Treatment contexts moderate and mediate therapeutic effectiveness, dependent on treatment expectations, beliefs, and risk evaluation. Uptake of tr
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15

Arden, Nigel, and Michael C. Nevitt. Epidemiology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0008.

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Despite the impact of osteoarthritis (OA) on patients and the health service, OA remains an elusive condition to define and treat. Traditionally, OA has been diagnosed using radiographs and more recently magnetic resonance imaging; however, the last 20 years of research have changed our thinking about the disease and its treatment. We know today that OA takes up to 10–15 years to develop, has a range of risk factors, and that there is a considerable discordance between symptoms and structural signs, such that new classifications and definitions are moving away from structural criteria to combi
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16

Aspden, Richard, and Jenny Gregory. Morphology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0011.

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The study of joint morphology can help us to understand the risk factors for osteoarthritis (OA), how it progresses, and aids in developing imaging biomarkers for study of the disease. OA results in gross structural changes in affected joints. Growth of osteophytes, deformation of joint components, and loss of joint space where cartilage has broken down are all characteristics of the disorder. Certain bone shapes as well as malalignment predispose people to future OA, or may be a marker for early OA. Geometrical measures, such as the alpha angle or Wiberg’s CE angle, used to be the primary too
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17

Henriksen, Marius, Robin Christensen, Berit L. Heitmann, and Henning Bliddal. Weight loss. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0023.

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Obesity is widely acknowledged as a risk factor for both the incidence and progression of osteoarthritis. Loss of at least 10% of body weight is recognized as a cornerstone in the management of obese patients with osteoarthritis, and can lead to significant improvement in symptoms, pain relief, physical function, and health-related quality of life. However, questions still remain surrounding optimal management and whether structural disease progression can be arrested. Given the significant health, social, and economic burden of osteoarthritis, especially in obese patients, it is imperative to
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18

Brand, Caroline A., and Ilana N. Ackerman. Delivery (organization and outcome). Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0036.

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This chapter considers the organization and delivery of care for osteoarthritis (OA) within the broader context of chronic condition management, and with a specific focus on the current OA literature. It describes factors that have influenced healthcare reforms for people with chronic conditions such as OA, and the development and characteristics of chronic condition models of care. The chapter also examines existing models of care for OA, which are commonly multidisciplinary in nature and situated within primary care, community care, or secondary/tertiary care settings. It summarizes current
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19

Holroyd, Christopher R., Nicholas C. Harvey, Mark H. Edwards, and Cyrus Cooper. Environment. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0038.

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Musculoskeletal disease covers a broad spectrum of conditions whose aetiology comprises variable genetic and environmental contributions. More recently it has become clear that, particularly early in life, the interaction of gene and environment is critical to the development of later disease. Additionally, only a small proportion of the variation in adult traits such as bone mineral density has been explained by specific genes in genome-wide association studies, suggesting that gene-environment interaction may explain a much larger part of the inheritance of disease risk than previously thoug
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20

Holroyd, Christopher R., Nicholas C. Harvey, Mark H. Edwards, and Cyrus Cooper. Environment. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0038_update_001.

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Musculoskeletal disease covers a broad spectrum of conditions whose aetiology comprises variable genetic and environmental contributions. More recently it has become clear that, particularly early in life, the interaction of gene and environment is critical to the development of later disease. Additionally, only a small proportion of the variation in adult traits such as bone mineral density has been explained by specific genes in genome-wide association studies, suggesting that gene-environment interaction may explain a much larger part of the inheritance of disease risk than previously thoug
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21

Manek, Nisha J., and George Muñoz. Common Rheumatic Diseases in the Elderly. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190466268.003.0022.

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With increasing longevity, the prevalence and impact of rheumatic diseases are projected to rise dramatically in the coming decades. Common rheumatic diseases such as osteoarthritis typically arise among the elderly. For diseases such as rheumatoid arthritis and gout, patients diagnosed at earlier ages carry the burden into their later years. Gout is associated both with comorbid conditions whose prevalence rises with age as well as with medications commonly prescribed in older people. These factors, along with the unique challenges associated with optimal diagnosis and treatment of arthritide
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22

Bannwarth, Bernard, and Francis Berenbaum. Systemic analgesics (including paracetamol and opioids). Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0029.

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Apart from non-steroidal anti-inflammatory drugs (NSAIDs), there are only two categories of systemic analgesics, namely paracetamol (acetaminophen) and opioids, that are currently available worldwide for clinical use. Paracetamol is poorly effective in relieving pain and improving function in patients with symptomatic osteoarthritis (OA). Furthermore, its safety profile is less favourable than classically thought. In fact, there is evidence paracetamol acts as a weak inhibitor of the cyclooxygenase enzymes. Given that paracetamol poses a lower risk of severe adverse events than NSAIDs while be
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