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Osteoarthritis (OA) is a common chronic degenerative joint disorder and a major cause of pain and disability, especially in the elderly. The prevalence is steadily rising due to an increase in life expectancy and certain lifestyle factors. OA is a complex dynamic process involving all tissues of the joint organ. Multiple risk factors are associated with the occurrence and progression of OA. There is extreme variability in presentation at different joint sites and between individuals. Management of OA involves a comprehensive approach consisting of preventative measures and numerous therapeutic modalities which should be tailored to individual needs. The family practitioner plays a vital role in the diagnosis of OA, the initiation of treatment and the ongoing monitoring of the condition.

Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that affects approximately 1% of the adult population. Some 30 to 40% of patients experience work disability within five years of onset of the disease, but early aggressive medical treatment has vastly improved the long-term outcome of RA. The combination of simple clinical tools to measure disease activity, the use of traditional disease-modifying anti-rheumatic drugs (DMARDs) early in the course of the disease and the introduction of targeted biologic agents for DMARD-resistant disease has greatly reduced the risk of joint deformities, physical disability and premature death. The family practitioner, by suspecting RA early in its course and jointly monitoring efficacy and toxicity of DMARDs with the rheumatologist, plays a pivotal role in improving the care and outcome of the RA patient.

Arthritis is a common cause of pain and disability in adults. In this article, the first in a series of two articles on arthritis, a clinical approach to musculoskeletal disorders is reviewed, with emphasis on the history and examination as the basis for diagnosis of common rheumatic disorders. A simple step-by-step clinical approach is discussed and basic investigations are considered in the context of clinical findings. Some common clinical pitfalls in diagnosis are highlighted. Broad principles of management of rheumatic diseases are briefly discussed as a prelude to the second article in which an in-depth approach to the management of rheumatoid arthritis is covered.