Osteoarthrosis (osteoarthritis) can be regarded as excessive joint wear and tear to the point where this becomes painful or produces stiffness. It is most disabling in weight-bearing joints, in which wearing away of articular cartilage is accompanied by underlying bony overgrowth and accumulation of a synovial effusion. The mechanism of the pain is uncertain: capsular strains and deep bone sensation may contribute. Diagnosis requires the exclusion of inflammatory arthritis such as rheumatoid; pointers to the latter are morning stiffness, raised ESR, positive tests for rheumatoid factor in the serum and radiological evidence of joint erosions.
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