Osteoarthritis is the most common forms of arthritis. Most often found along with advancing age, patients over the age of 75 have an 80% chance of having osteoarthritis. It is the second widest cause of disability in the United States.
Controversy continues to swirl around the treatment of osteoarthritis. Emerging information adds to the debate about whether the treatment benefits of NSAIDs and Cox-2 Inhibitors outweigh their possible adverse side effects. There is also much discussion related to the use of alternative and adjunctive therapies to alleviate pain, improve mobility and function, and slow progression of disease.
Differential diagnosis of osteoarthritis requires taking a careful patient history. Patients often experience pain that worsens with weight-bearing activities and improves with rest. Morning joint stiffness fades throughout the day.
The American College of Rheumatology recommends nonpharmacologic approaches such as weight loss, use of exercise, physical therapy and assistive devises as first line treatment. A variety of additional treatment options, including nonsteroidal antiinflammatory topicals, intraarticular injections, hyaluronic preparations, complementary therapies, and surgical interventions have their place in treating patients with osteoarthritis. It is critical to balance the demonstrated efficacy of NSAIDs and Cox-2 inhibitors with the realities of the cardiovascular, renal and GI safety issues. Careful differential diagnosis and treatment selection can help minimize symptoms and side effects as well as preserve function in patients with osteoarthritis.

This activity is intended for nurse practitioners and other advanced practice clinicians involved in the care of patients with osteoarthritis.

After completing this activity, participants should be better able to:

• Identify and implement the differential diagnosis for Osteoarthritis
• Review pharmacological and non-pharmacological treatment options for OA
• Describe the efficacy benefits and risks of NSAIDs and Cox-2 inhibitors

M. Susan Burke, M.D., FACP
Clinical Assistant Professor, Thomas Jefferson University
Director, Internal Medicine Clinical Care Center
Lankenau Hospital
Wynnewood, Pennsylvania

Joseph M. Grisanti, M.D., FACP, FACR
Assistant Clinical Professor of Medicine
State University of New York at Buffalo
Chief of Rheumatology, Mercy Hospital of Buffalo
Medical Director, Buffalo Rheumatology Associates

This activity has been planned and implemented in accordance with (NPACE) Nurse Practitioner Associates for Continuing Education.  NPACE is an approved provider of continuing nursing education by the Massachusetts Association of Registered Nurses, Inc., an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  This activity is supported by an independent educational grant from Merck & Co., Inc.