If your doctor starts you on a drug treatment for your osteoarthritis, arthritis or “joint pain,” a physical examination of the affected joint should be documented in your charts.

If you are diagnosed with osteoarthritis of the hip or knee, a pain and functional assessment should be done annually and when you are new to a practice.

If you have had a diagnosis of osteoarthritis of the hip or knee for more than three months, your doctor should have educated you or recommended education about the disease, treatment options and self-management techniques you can employ.

Within the first three months of a diagnosis of osteoarthritis of the hip or knee, your doctor should determine first if you are able to exercise and, if so, prescribe a directed or supervised muscle strengthening or aerobic exercise program. This program should be reviewed at least once a year.

If you are overweight (meaning you have a body mass index of 27 kg/m or higher), then your doctor should advise you on losing weight at least once a year. If your osteoarthritis is in your hip or knee, the doctor also should inform you of the benefits of losing the weight in relation to your osteoarthritis symptoms. If you have osteoarthritis of the hip or knee and have been overweight for more than three years, your doctor should refer you to a weight loss program.

If you have osteoarthritis of the hip or knee and have difficulty walking enough to perform daily living activities, such as getting out of bed, going to get the mail or going to the toilet, for more than three months, your doctor should assess you for an ambulatory assistive device, such as a cane, insoles, knee brace or orthotics. If you have difficulty with non-ambulatory activities, such as brushing your teeth, cooking or getting dressed, then your doctor should assess you for self-help aids such as extended-length or wide-grip assistive devices that will help you complete these tasks.

Unless you are unable to take it for some reason, acetaminophen should be the first drug treatment prescribed by your doctor for mild or moderate osteoarthritis pain. If the doctor wishes to prescribe a different medication, he should reflect in your chart that the reason why you cannot take acetaminophen or that a trial of maximum-dose acetaminophen was unsuccessful in treating your osteoarthritis.

If you have severe OA pain in your hip or knee that has not responded to any type of drug or non-drug therapy, your doctor should refer you to an orthopaedic surgeon to discuss surgery as an option for treatment.

If you have osteoarthritis of the hip or knee and report to your doctor that you are unable to participate in activities you could once do and no X-rays have been taken in the preceding three months, then you should have a knee or hip X-ray within the next three months.

Source:  MacLean CH, Saag KG, Solomon DH, Morton SC, Sampsel S, Klippel JH. Measuring quality in arthritis care: Methods for developing the Arthritis Foundation's quality indicator set. Arthritis Care and Research 2004; 51: 193-202.