Clinical profile of Filipino patients with osteoarthritis seen at two arthritis clinics (for the osteoarthritis network of the Philippine general hospital)

      Purpose: Around 4.2 million Filipinos suffer from osteoarthritis (OA). OA leads to significant deterioration in quality of life. With increasing obesity and ageing of the population, this study aims to describe the modern-day Filipino with OA.
      Method: This study reviewed clinical charts of patients diagnosed with primary OA in 2 arthritis clinics - Rayuma Klinik and Arthritis Clinic of the Philippine General Hospital (PGH), from January 2008 to May 2011. Demographic data, risk factors, clinical presentation, and management were extracted. Descriptive statistics were used.
      Results: Eight hundred fifty-nine patients had primary OA. There was female predominance (female:male = 3:1). Mean age at diagnosis was 63 years for both genders. The average interval between symptom onset and consult is 4 years. Males consulted a mean of 10 months later than females. Mean BMI was 27.1 kg/m2. Female patients were mostly overweight; males mostly obese. Sixty-eight percent had concomitant illnesses with hypertension (53%), dyslipidemia (16%), and diabetes mellitus (13%) being the most common. Majority denied ever smoking (71%) and ever taking alcoholic beverages (59.7%). Females (94.7%) developed OA symptoms an average of 12 years after menopause. There was paucity of data regarding patients’ vocational or daily activities, and educational status. Cases from the PGH (33%), belonged to low socioeconomic class.
      Chief complaint was pain in 92.8%. Most common physical examination findings were crepitus (70.8%) and Heberden's nodes (13.0%) for knee and hand OA, respectively. Majority (56.6%) had a Kellgren-Lawrence score 2.
      The most common joint involved was the knee (62.5%), the knees and hands, (14.3%), and generalized in 13.5%. Hip involvement accounted for only 2.9% of cases, with 4 cases concurrent with knees, and 7 with generalized OA. Most (70.5%) had bilateral OA and 80.3% had more than 1 affected joint.
      Less than 25% had documented non-pharmacologic management. Pharmacologic intervention most commonly given included glucosamine sulfate (45.5%), paracetamol (42.8%), and a cox-2 inhibitor NSAID (40.6%). Less than 8% were given intra-articular steroids and hyaluronic acid, or were referred for surgery.
      Conclusion: We described the modern day Filipino OA patient, gleaned from two medical specialty clinics. Most are middle-aged to elderly females, with joint pain most common in the knees. Clinical characteristics are consistent with those in literature. There is need to improve documentation of risk factors, non-pharmacologic management, as well as referral for surgery. This is a hypothesis-generating paper that has given rise to a formal registry done together with the departments of Orthopedics and Rehabilitation Medicine of PGH.