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Primary Osteoarthritis

Last updated Oct. 23, 2018

Approved by: Krish Tangella MD, MBA, FCAP


An individual showing Heberden's nodes in the fingers due to osteoarthritis.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Primary Generalized Osteoarthritis
  • Primary OA

What is Primary Osteoarthritis? (Definition/Background Information)

  • Osteoarthritis (OA) is a painful joint disorder characterized by the progressive degeneration of the articular cartilage that covers the bone surface of joints
  • Primary Osteoarthritis develops from factors of age-related wear and tear i.e., the cartilages of joints wear down gradually over time causing associated bone changes
  • It may be enhanced by hereditary factors, such as a positive family history or one’s genetic predisposition, and work and lifestyle factors that include obesity and/or occupation
  • Primary Osteoarthritis is mostly observed in middle-aged and older adults, beyond age 55-60 years. Typically, women are more at risk than men
  • It is a gradually progressive and degenerative disorder that affects any joint(s) in the body. Since, the condition may affect any of the joints, it is also known as Primary Generalized Osteoarthritis
  • Commonly, the condition may involve multiple joints such as the finger joints, hip joint, or knee joints. Over time, chronic pain and joint stiffness may be noted
  • Early and adequate treatment is necessary to control the progression of Primary Osteoarthritis. The treatment associated with the condition includes both nonsurgical and surgical methods. The prognosis is good with early treatment in a majority of individuals

Who gets Primary Osteoarthritis? (Age and Sex Distribution)

  • The onset of Primary Osteoarthritis is usually observed in individuals over the age of 55 years
  • A high percentage of individuals who develop this degenerative and progressive disorder are middle-aged to elderly women

What are the Risk Factors for Primary Osteoarthritis? (Predisposing Factors)

The main risk factor for Primary Osteoarthritis is advancing age, since it is a gradually progressing condition.

  • Women are more susceptible to the condition than men, especially after menopause
  • Studies have indicated that osteoarthritis may have a genetic component to it
  • Also, individuals with close relatives or siblings with the condition are at an increased
  • Other factors that may play a role in the development of the condition include trauma from injury, obesity, occupation-related factors, certain medical conditions, and prolonged physical activity

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Primary Osteoarthritis? (Etiology)

  • Primary Osteoarthritis develops from the gradual wear and tear of joints in the body that occur with aging. In this condition, there is a wearing away of the cartilage with associated bone changes
  • With advancing age, the body repair mechanisms are also not able to cope up with the loss of cartilage
  • Some individuals have an increased risk due to certain genetic factors that are known to play a role in the development of osteoarthritis
  • Other factors that may aggravate the condition include obesity causing abnormal stress on the joints, overuse of the joints, and trauma to the joints

What are the Signs and Symptoms of Primary Osteoarthritis?

Primary Osteoarthritis is gradual degenerative disorder that usually worsens over time. The common signs and symptoms of the condition include:

  • Noticeable pain and tenderness in the affected joint
  • Swelling in the region
  • Stiffness and reduced mobility of the joint
  • Formation of bone spurs around the joint
  • A single joint or multiple joints may be affected

How is Primary Osteoarthritis Diagnosed?

Diagnostic methods that a physician may use to help diagnose Primary Osteoarthritis may include:

  • Physical examination: The physician will perform a thorough physical examination to determine, if the individual has osteoarthritis. In addition to this, a complete medical history may aid in arriving at a diagnosis
  • X-ray of the affected joint: X-rays use radiation in order to produce images of the joint, which can help the physician rule-out other possible causes for pain and discomfort
  • Various blood tests to rule-out other conditions that may cause similar symptoms
  • Joint fluid analysis of affected joint: Occasionally, fluid may accumulate around a joint. Analysis of this fluid will give clues regarding the cause of the joint fluid accumulation, which causes pain and disability. A needle is inserted into the joint space and the accumulated fluid aspirated with a syringe. It is then sent to a laboratory for analysis, to determine:
    • The type of cells present in the fluid
    • Chemical composition of the fluid
    • The presence of crystals (examination of fluid under a microscope)
  • Ultrasound imaging of joint: The use of high-frequency sound waves to generate a thorough image of the affected joint
  • CT, MRI scan of the affected joint

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Primary Osteoarthritis?

Primary Osteoarthritis is a progressive condition that gradually worsens over time. The complications of the condition may include:

  • Chronic pain and stiffness within the joint, which may prevent individuals from performing their daily routine activities
  • Permanent disability
  • Decreased quality of life

How is Primary Osteoarthritis Treated?

The treatment of Primary Osteoarthritis includes nonsurgical and surgical methods. A healthcare provider may start with non-surgical treatment methods, before adopting surgical procedures and techniques. These include:

  • Rest: Any activity that aggravates the joint condition further should be avoided. The physician usually advises to refrain from all such activities until the symptoms stop
  • Heat and ice: Applying a damp heated towel or ice to the joint can help reduce pain and swelling
  • Splint or brace: A physician may prescribe some type of padded splint or cast, to help keep the joint in a stable position, especially while sleeping
  • Non-steroidal anti-inflammatory medication: Medications, such as ibuprofen and naproxen, can help decrease the joint pain and swelling
  • Corticosteroid medications, such as prednisone, help provide temporary relief of symptoms and in improving the range of motion within the joint. It is important to note that corticosteroid injections may only give temporary relief. Prolonged episodes of such injections can injure the joints in the long-run
  • Viscosupplementation: Normal fluid within a joint contains a material called hyaluronic acid. When a joint is affected by osteoarthritis, a reduction of hyaluronic acid level occurs within the joint. Such a decreased acid level will decrease the ability of the joints to lubricate. Viscosupplementation is a minimally-invasive technique that is commonly used when treating osteoarthritis. During this procedure, small doses of hyaluronic acid are injected into the arm/leg to relieve pain
  • Physical therapy: After the symptoms have decreased, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as provide flexibility to the muscles

Surgical treatment measures include:

  • Joint fusion: Joint fusion is a surgical technique that involves the removal of the arthritic part within the joint and fusing two surrounding bones together. The purpose of this procedure is to relieve pain, stabilize the joint, and regain some range of motion in the affected joint
  • Total arthroplasty: It is a surgical intervention tool in which the joint is completely removed. The arthritic joint that is removed is then replaced by a metal and plastic prosthetic implant. A physician will recommend this surgical procedure, if the degenerative disorder affects the entire joint

How can Primary Osteoarthritis be Prevented?

A few recommendations to help prevent Primary Osteoarthritis include:

  • Individuals, who maintain a healthy diet, may decrease the chance of developing this condition
  • Estrogen replacement therapy can decrease the incidence of osteoarthritis after menopause in women
  • Using correct posture and tools that decrease stress on joints in the work place can decrease incidence of the condition due to occupational causes
  • Proper treatment of diabetes
  • Maintaining a healthy body weight can help prevent abnormal pressure on the joints
  • Individuals, who participate in any high-risk sports, such as football and basketball, should wear appropriate safety gear to help prevent serious injuries to their joints

What is the Prognosis of Primary Osteoarthritis? (Outcomes/Resolutions)

The long-term prognosis of Primary Osteoarthritis depends on the severity of this degenerative condition.

  • If osteoarthritis is detected early and proper aggressive treatment provided; then, the prognosis is good in a majority of individuals, if no serious complications are noted
  • In general, without treatment, a high percentage of individuals who develop this condition may experience a lifetime of gradual degeneration that can be debilitating

Additional and Relevant Useful Information for Primary Osteoarthritis:

The following DoveMed website link is a useful resource for additional information:


What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 23, 2018
Last updated: Oct. 23, 2018