Neurologic findings such as paresthesia and difficulty with balance, and, in extreme cases, confusion may be found in vitamin B12 deficiency anemia . It is a degenerative disease without systemic manifestation or inflammation. The most problematic joint involvement is typically in the hip and knee. Worst symptoms are reported with use, and in contrast with rheumatoid arthritis, there is minimum morning stiffness. OA risk factors include a positive family history and contact sport participation.
Obesity is also a risk factor, especially with hip and knee involvement.
In OA, the articular cartilage is roughened and wears away. Bone spurs may form and the sensorial membrane thickens. As a result, the joint space narrows. The clinical presentation in OA includes an insidious onset of symptoms, including use-related joint pain that is relieved by rest, and joint stiffness that occurs with rest but resolves with less than 15 minutes of activity. Physical exam reveals smooth, cool joints and coarse credits.