1、骨 关 节 炎-从指南到临床柳州市工人医院风湿免疫科住院医师培训概 念 骨关节炎是以软骨变性、破坏、骨质增生及滑膜炎性改变为主要表现的慢性关节炎。名称 : 骨关节炎 /osteoarthritis( 骨性关节炎 / 退行性骨关节病 / 骨关节病 )骨关节炎 最新概念“ Osteoarthritis is a group of overlapping, yet distinct diseases, which may have different etiologies but result in similar biological , morphological, and clinical o
2、utcomes. The disease processes not only affect the articular cartilage, but also involve the entire joint, include the subchondral bone, ligament capsule, synovial membrane, and periarticular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, and full-t
3、hickness loss of the joint surface. ” -Updated by ACR in 2000骨关节炎是相互有重叠的一组疾病，虽然病因不同，但是都会产生相似的生物学、形态学和临床症状。疾病的进展不仅仅累及关节软骨，而且累及整个关节，包括软骨下骨、关节囊、滑膜和关节周围肌肉。EULAR evidence based recommendations for the diagnosis of knee osteoarthritis Knee OA is characteried clinically by usage-related pain and/or functio
4、nal limitation. It is a common complex joint disorder showing focal cartilage loss, new bone formation and involvement of all joint tissues. Structural tissue changes are mirrored in classical radiographic features.膝骨关节炎临床特征是与活动相关的疼痛和/或功能受限，是一种常见复杂的关节疾病，表现为软骨丢失及新骨形成，并累及整个关节组织。Ann Rheum Dis published
5、 online September 17, 2009Woolf and Pfleger. WHO Bulletin 2003膝骨关节炎的流行病学（按年龄、性别和地区划分）骨关节炎流行病学12.80.34 0.3 1.102468101214OA RA AS Gout不同关节炎的患病率比较患病率%Arthritis Res Ther 2008, 10: R17.危险因素（IL1、IL6、TNF）栗占国 中华全科医师杂志2005年发 病 机 制病 理 变 化 累及软骨、软骨下骨板、滑膜等关节周围组织 表现为软骨破坏、软骨下硬化、囊性变、骨赘形成临 床 表 现1 、症状 疼痛： 最常见活动时或活动后，休息可减轻严重时休息不能缓解，夜间疼痛 晨僵：一般 30 分钟、轻度 活动受限2 、体 征 关节活动弹 或 ： 关节 骨性 能受限 关节 和 形：可 等 痛
