Osteoarthritis – assessment and treatment at Charlottenlund Privathospital

What is osteoarthritis?

Osteoarthritis affects the entire joint—cartilage, bone, joint capsule and surrounding muscles—not just the cartilage. According to the Danish Society of Rheumatology’s national osteoarthritis treatment guidelines, the joint cartilage gradually breaks down, the joint space narrows, and bony growths form along the edges of the joint. The condition progresses slowly and fluctuates: periods with few symptoms are interrupted by flare-ups, when the joint swells and becomes more painful. The joints most commonly affected are the knees, hips, finger joints and the base of the big toe.

According to the National Health Profile, 20.9% of Danish adults reported having osteoarthritis, and treatment guidelines estimate that up to 70% of people over 65 have osteoarthritis of the knee or hip. Prevalence increases with age, but osteoarthritis is not an inevitable part of getting older—many people have changes visible on X-rays without symptoms, while others have symptoms without major changes.

What are the symptoms of osteoarthritis?

Typical signs include pain with activity and when starting to move after resting, which eases once you get going and worsens again with prolonged activity. Stiffness after rest is brief—usually less than half an hour—unlike the prolonged morning stiffness of inflammatory arthritis. The joint may creak, feel thickened and gradually lose mobility. In the fingers, hard lumps can develop at the end and middle joints and at the base of the thumb; in the knees and hips, pain is often felt when climbing stairs, standing up from a chair and walking on uneven ground.

During a flare-up, the joint may swell, become warm and hurt even at rest, making it difficult to distinguish from inflammatory arthritis or crystal arthritis. Osteoarthritis does not cause fatigue, fever or elevated inflammation markers—if these are present, they point to another condition that needs to be investigated.

What causes osteoarthritis?

Osteoarthritis develops when the load on a joint over time exceeds the cartilage’s ability to repair itself. According to treatment guidelines, age, genetic predisposition, excess weight, previous joint injuries and misalignment are the main risk factors. Excess weight puts particular strain on the knees and hips and significantly increases the risk. Previous meniscus or cruciate ligament injuries and fractures near a joint can cause what is known as secondary osteoarthritis. Heavy physical work involving repetitive strain can play a role, while ordinary exercise—including running—does not cause osteoarthritis in healthy joints.

How is osteoarthritis diagnosed?

The assessment has two aims: to confirm osteoarthritis and rule out inflammatory arthritis, crystal arthritis or other causes that require different treatment. The patient’s history—which joints are affected, the pattern of pain in relation to activity and rest, how long stiffness lasts, and any previous injuries—and a clinical examination of joint mobility, swelling, warmth and bony growths are usually enough to make a diagnosis. Ultrasound can show cartilage changes, bony growths and fluid in the joint, and detect inflammation of the joint lining if the joint has flared up.

Blood tests for inflammation and arthritis are taken when the diagnosis is uncertain or when joints are swollen and warm. They are normal in osteoarthritis. If X-rays are needed, the specialist will refer you; X-ray changes are used to confirm the diagnosis and assess its severity, but they do not determine treatment—which depends on symptoms and function.

How is osteoarthritis treated?

Osteoarthritis cannot be reversed, but symptoms and function can be significantly improved. According to treatment guidelines, first-line treatment consists of information about the condition, structured exercise to strengthen the muscles around the joint, and weight loss for people who are overweight—measures that reduce pain and improve function for most people. Arthritis medication to relieve pain and inflammation can be used during flare-ups.

Joint injections—corticosteroids or hyaluronic acid—are not routinely offered for osteoarthritis because their effects are short-lived, and exercise has been shown to be at least as effective. Severe osteoarthritis with significantly impaired function is referred for an orthopaedic assessment. At Charlottenlund Privathospital, we provide assessment, diagnosis and advice on exercise, weight management and medical treatment.

When should I see a rheumatologist?

A rheumatology assessment is appropriate when joint pain persists despite exercise and reducing strain; when it is unclear whether the cause is osteoarthritis or inflammatory arthritis—for example, if joints are swollen and warm, morning stiffness lasts more than half an hour, or your GP finds elevated inflammation markers; when several joints are affected; or when a joint repeatedly flares up. Osteoarthritis in younger people with no known injury should always be investigated.

Assessment at Charlottenlund Private Hospital

Assessment is carried out by specialists in rheumatology and takes place on an outpatient basis. The initial consultation typically lasts 20–30 minutes; the specialist performs the ultrasound scan, and blood tests are taken the same day if the diagnosis is uncertain. If osteoarthritis is confirmed, you will receive advice on exercise, weight management and medical treatment, and your GP will receive a note.

Most patients come through health insurance; insurers typically require a referral from your GP and prior authorisation before an appointment can be booked. No referral is needed if you are paying for your treatment yourself, and prices are listed in the price list. Appointments can be booked online around the clock or by phone on 44 98 19 21 Monday to Friday, 08:00–14:00. Outside phone hours, the digital phone assistant Anna can book, cancel and reschedule appointments.