The most common sign of osteoarthritis is:

AIIMS Delhi NO-2016

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO-2016

Explanation

Pain is the main presenting symptom of osteoarthritis, often described as a deep, achy feeling.
The pain is characteristically mechanical, meaning it worsens with joint use and weight-bearing, and improves with rest.
As the disease progresses, pain can become more constant and may even occur at night, disrupting sleep.
Pain in OA originates from structures like the subchondral bone, synovium, and joint capsule, as the cartilage itself has no nerves.

Option A: While joint stiffness is a feature of OA, it is typically brief (less than 30 minutes) and occurs after periods of inactivity (a phenomenon called 'gelling'). It is not the most predominant or universal symptom compared to pain.
Option B: This statement is the opposite of what occurs in osteoarthritis. Symptoms, including pain, stiffness, and associated muscle weakness, typically worsen as the day progresses due to cumulative joint use and activity.
Option D: Swelling can be present in OA, but it is not as common or consistent as pain. It can manifest as hard, bony enlargements (osteophytes) or, less frequently, as soft tissue swelling (effusion).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Osteoarthritis as background academic context rather than a clinical decision trigger.
Nurses must perform a thorough pain assessment, including its location, character, onset, duration, and aggravating/relieving factors, to differentiate OA from other types of arthritis.
Patient education is a key nursing role, focusing on pain management strategies such as balancing rest and activity, weight management, and the proper use of prescribed analgesics.
What if? If a patient with known knee OA presents with a suddenly hot, swollen, and exquisitely painful joint, the nurse should suspect a superimposed condition like septic arthritis or a gout attack, which requires immediate medical evaluation.

How to Approach the Question

First, identify the core subject of the question, which is the 'most common sign' of osteoarthritis.
Recall the key clinical features of osteoarthritis. The disease is primarily degenerative ('wear and tear').
Evaluate each option based on your knowledge. Pain is the classic, predominant symptom that drives patients to seek medical care.
Consider the characteristics of the other symptoms. Stiffness in OA is typically brief, and swelling is not always present.
Eliminate the option that describes symptoms improving in the evening, as this is contrary to the mechanical nature of OA pain.
Conclude that pain is the most consistent and common sign among the choices.

Concept Tested & Keywords

QFp3ClZD1rs3gL8gcRP2mx

E6 Medicine Davidson Principles Practice 24e p. 1029-1031

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1197-1199

E6 Medicine Harrison 22e Part 2 p. 857-859