Clinical assessment of the osteoarthritis patient

It is becoming apparent that the disease process of osteoarthritis should b e regarded separately from the clinical syndrome of joint pain, use-related stiffness and disability. The latter may best be approached as a chronic r egional pain disorder that requires attention to physical, psychological an d social factors as well as those related to the disease process. This chap ter sets out to look at some of the practical implications of taking this v iew for the clinical assessment. Starting with the syndrome of hip, knee or hand pain in older adults in the community, we consider what leads people to consult, what the important features to assess might be, the role of ima ging in the clinical assessment of osteoarthritis, and finally how a manage ment plan could be formulated. The usefulness of assessing clinical osteoarthritis as a regional pain diso rder is uncertain. Even if this were demonstrated, the concept of osteoarth ritis as a structural disease should be retained as an integral part.