Study on Osteoarthritis at Tertiary Care Centre and How to Diagnose and to Differentiate Primary from Secondary Osteoarthritis and Methods of Managements and Prevention and Rationale of NSAIDs Prescriptions in Osteoarthritis

Aim: To study the clinical features of osteoarthritis of the commonly involved joints. To evaluate the most useful and easily available diagnostic approaches on osteoarthritis. To identify quite beneficial modalities of non-pharmacologic management in osteoarthritis. To identify the suitable pharmacologic treatments of OA in above middle ages and in old ages. Objective of the Study: As everyone aware, osteoarthritis is a commonest disability prone disease. As against in the past, quite large number of cases are presenting with this disease, not just in old but from above Middle Ages. All over the globe, in both sexes, the life expectancy is being appreciably increased. Likewise, because of the rise in affluency and easy reach of opulent diets, most of them appears plumb and bellies and unfortunately, its all, often being seen in young and in middle ages. Thus, it ultimately leads to secondary flat foot and increase in intra-articular hypertension, medial and lateral tibiofemoral compartmental stress and repetitive injuries to internal structures of joints. When any one of these modifiable, non-modifiable and perpetual and repetitive causes are not removed, then, one must welcome, early onset of osteoarthritis. There are numerous cases are coming with features of OA to rheumatology out-patient department, I have aimed to do this systematic and prospective study on osteoarthritis from August 2006 to July 2018 and it was conducted in two different centres, namely in rheumatology out-patient department of the Government Mohan Kumaramangalam Medical College and Hospital, Salem and another one in Akitha Hospital, Centre of Excellence for Autoimmune Diseases, Seelanaickenpatti, Salem. Results: More than a decade of my experiences on 3208 osteoarthritis cases from rheumatology out-patient department of Government Mohan Kumaramangalam Medical College and Hospital and from Akitha Hospital, Centre of Excellence for Auto Immune diseases, Salem, Tamil Nadu State, India are have been included for this systematic and prospective on going study on osteoarthritis with basic diagnostic work up, and wherever necessary, appropriate non-pharmacologic and pharmacologic treatments have been suggested. By and large, the osteoarthritis, quite often rheumatologist are being seen OA cases with lot of wrong or misdiagnosis and with erroneous treatment and exposed strong dose of steroid and with various DMARDs as rheumatoid arthritis. Thus, in this article, I have taken meticulous attempts to conveys to our colleagues to the ways to do basic diagnostic workup and disclose what are the common pitfalls could come across by treating doctors either in investigation or in diagnosis of OA before initiations of proper treatment. Conclusion: Proper clinical diagnosis and relevant basic investigations are enough for diagnosing osteoarthritis. At an early stages itself, when the modifiable and non-modifiable causes for the OA are identified and when it is removed or effectively modified with meticulous non-pharmacologic or by pharmacologic management, then there wont be any necessity for pain killers are required and in near future, as there are more promising treatments like cartilage repair, stem cell therapy and gene therapy are in the reach of everyone and surely, there is a visible hope for OA populations that, they can lead not just pain free life and they can aim for disease free life.