| Overall key points |
Hand osteoarthritis is the most common musculoskeletal disorder.
Three-quarters of women aged 60-70 years old have X-ray evidence of hand osteoarthritis.
Paracetamol is the recommended first-line analgesic.
Topical therapies are also of use in hand osteoarthritis.
Holistic assessment is essential.
Part 1 Epidemiology
Osteoarthritis (OA) is the most common musculoskeletal disorder and can involve any joint, but is most prevalent in the spine, hand, knee and hip joints.
OA causes damage to and loss of the smooth joint cartilage, accompanied by thickening of the joint lining and compensatory bone overgrowth. Although common in older age groups, leading to the popular belief that it is caused by ageing, OA can affect younger people with considerable economic impact on society.1 OA results from a complex interplay of multiple factors, with the majority of people having primary OA which has no known cause. In some patients, OA can be secondary to joint integrity, genetic predisposition, local inflammation, mechanical forces and cellular and biochemical processes.