Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive polyarticular joint pain, stiffness, and functional limitation. Symptoms are characteristically worse with activity and prolonged use, improving with brief rest. Morning stiffness is reported, typically lasting <30 minutes. Patient reports involvement of multiple joints, including [specify joints, e.g., DIP/PIP joints, knees, hips]. No systemic symptoms such as fever, significant weight loss, or prolonged inflammatory morning stiffness.
Clinical Examination Findings
Physical examination reveals polyarticular involvement with palpable bony enlargements (Heberdenโs/Bouchardโs nodes). Joint lines demonstrate tenderness on palpation. Crepitus is noted upon passive and active range of motion. Joint range of motion is restricted in multiple planes with associated periarticular muscle atrophy in severe cases. No significant joint warmth, erythema, or systemic signs of inflammatory arthritis. Stability testing is within normal limits for age, barring mechanical interference.
Treatment Protocol
Management plan includes: 1. Non-pharmacological: Physical therapy for strengthening and range-of-motion exercises, weight management, and use of assistive devices. 2. Pharmacological: Topical NSAIDs or capsaicin for localized relief; oral acetaminophen or NSAIDs as needed for pain control. 3. Intra-articular injections: Consider corticosteroid or hyaluronic acid injections for refractory symptomatic joints. 4. Referral: Orthopedic consultation if surgical intervention (e.g., arthroplasty) is indicated.