Which finding is most characteristic of osteoarthritis on history and examination?

• A. Bilateral morning stiffness that is worse in the morning
• B. Unilateral joint pain with stiffness most noticeable after inactivity
• C. Systemic fever and malaise
• D. Erythema and warmth of a joint without systemic symptoms

Answer: (B)

Osteoarthritis presents as a mechanical pain pattern. The most characteristic history is pain centered in one joint (often a weight-bearing joint) that worsens with use and improves with rest, with only brief stiffness after inactivity. Systemic symptoms like fever or malaise, and joint warmth with erythema, point away from OA and toward inflammatory or septic processes. So a unilateral joint pain with stiffness after inactivity fits OA best because it reflects the noninflammatory, wear-and-tear nature of the condition.