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''NICE guidelines''
advice - weight loss, muscle strengthening exercize and aerobic fitness
//1st line// - PCM and topical NSAID (knee or hand)
//2nd line// - oral NSAID/COX2 (not if already on aspirin and with PPI), Opioids, Capsaicin cream, I/A steroid
also supports, braces, TENS
refer for joint replacement if still pain

Glucosamine - some short term benefit but not on NHS as cost effectiveness not established

Heberden's nodes suggest OA (at DIP)
Bouchard - (PIP) may also be seen in OA

''X-ray changes of osteoarthritis''
    decrease of joint space
    subchondral sclerosis
    subchondral cysts
    osteophytes forming at joint margins