CURRENT APPROACH TO THE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF OSTEOARTHRITIS

WOS: 000291327500019EULAR OA Task Force undertook a project to develop evidence-based recommendations for diagnosis of hand and knee OA as there was no guideline primarily for the purpose of clinical diagnosis of osteoarthritis. However, several guidelines were published for the treatment of OA. In this review, the following guidelines related to the treatment were taken into consideration: EULAR knee OA (2003), EULAR hip OA (2005), EULAR hand OA (2007), OARSI hip and knee (2008) treatment recommendations and NICE clinical guideline (2008). Paracetamol is the oral analgesic to try first. Topical applications (NSAID, capsaicin) have clinical efficacy and are safe. In patients with an increased gastrointestinal risk, non-selective NSAIDs and effective gastroprotective agents, or selective COX 2 inhibitors should be used. Opioid analgesics, with or without paracetamol, are useful alternatives in patients in whom NSAIDs, including COX 2 selective inhibitors, are contraindicated, ineffective, and/or poorly tolerated. SYSADOA (glucosamine sulphate, chondroitin sulphate, ASU, diacerein, and hyaluronic acid) have symptomatic effects and may modify structure Infra-articular injection of long acting corticosteroid is indicated for flare of knee pain, especially if accompanied by effusion