FOR YOUNG DOCTOR ASSISTING: OSTEOARTHRITIS – EASY TO DIAGNOSE, HOW TO TREAT?

Presents the questions of diagnosis and modern approaches to osteoarthritis therapy. Review requirements for diagnosis, classification of osteoarthritis, as well as paid attention non-pharmacological and medication treatments. Consistently described tactics of the doctor in diagnosing the disease and identifying non-inflammatory nature of pain. The reasons for the development of joint pain in osteoarthritis are discussed. It is shown that in primary osteoarthritis knee, hip joints, proximal and distal interphalangeal joints of the hand (Geberden's and Bushar's nodules) are affected, the first metatarsal and metacarpophalangeal joint. Indications for laboratory and instrumental diagnostics, X-ray stages of osteoarthritis are described. The methods of non-drug therapy are described in detail: weight loss, exercise therapy, use of cane, insoles, orthoses. Attention is paid to the rules of using the cane and exercises on the quadriceps muscle of the thigh. Discuss drugs quickly and slowly modify symptoms of the disease. The indications for the use of nonsteroidal anti-inflammatory drugs, acetaminophen, tramadol are analyzed. The importance of assessing the safety of non-steroidal anti-inflammatory drugs before prescribing to the patient is emphasized. Doses and indications for the use of chondroitin, glucosamine, diacerein, avocado/soybean unsaponifiables compounds, hyaluronic acid are described. It is noted that the effect of these drugs develops by the eighth week of use. The moments of the patient's referral to the orthopedist's consultation and the importance of timely endoprosthesis replacement are determined. In the context of the problem of osteoarthritis, the main task of young doctors is to treat this disease in accordance with current international and national recommendations.