Diagnosis of Osteoarthritis

Diagnostic Test list for Osteoarthritis:

The list of medical tests mentioned in various sources as used in the diagnosis of Osteoarthritis includes:

• Physical examination
• X-rays
• Tests to rule out other types of arthritis

Osteoarthritis Diagnosis: Book Excerpts

• Diagnosis - Psoriatic arthritis
• Diagnosis - Rheumatoid arthritis
• Diagnosis - Osteoarthritis
• Diagnosis - Juvenile rheumatoid arthritis
• Diagnosis - Psoriatic arthritis
• Diagnosis - Rheumatoid arthritis
• Diagnosis - Osteoarthritis
• Diagnosis - Juvenile rheumatoid arthritis

Tests and diagnosis discussion for Osteoarthritis:

No single test can diagnose osteoarthritis. Most doctors use a combination of the following methods to diagnose the disease and rule out other conditions:

Clinical History: The doctor begins by asking the patient to describe the symptoms, and when and how the condition started. Good doctor-patient communication is important. The doctor can give a better assessment if the patient gives a good description of pain, stiffness, and joint function, and how they changed over time. It is also important for the doctor to know how the condition is affecting the patient's work and daily life. Finally, the doctor also needs to know about other medical conditions and whether the patient is taking any medicines.

Physical Examination: The doctor will check the patient's general health. Joints bothering the patient will be examined, including checking reflexes and muscle strength. The doctor will also observe the patient's ability to walk, bend, and carry out activities of daily living.

X Rays: Doctors take x rays to see how much joint damage has been done. X rays of the affected joint can show such things as cartilage loss, bone damage, and bone spurs. But there is often a big difference between the severity of osteoarthritis that the x ray shows and the degree of pain and disability the patient has. And x rays may not show early osteoarthritis damage (before much cartilage loss has taken place).

Other Tests: The doctor may order blood tests to determine the cause of symptoms. Another common test includes "joint aspiration," where fluid is drawn from the joint for examination.

It is usually not difficult to tell if a patient has osteoarthritis. It is more difficult to tell if the disease is causing the patient's symptoms. Osteoarthritis is so common, especially in older people, that other conditions may play a role in the symptoms. The doctor will try to find out what is causing the symptoms, ruling out other disorders and identifying conditions that may make the symptoms worse. The severity of symptoms in osteoarthritis is greatly influenced by the patient's attitudes, anxiety, depression, or daily activity level. (Source: excerpt from Handout on Health Osteoarthritis: NIAMS)

Diagnosis of Osteoarthritis: medical news summaries:

The following medical news items are relevant to diagnosis and misdiagnosis issues for Osteoarthritis:

• Alternative therapies not satisfactory for osteoarthritis
• Bone problems for obese kids
• Co-morbidities override high blood pressure
• More news »

Diagnostic Tests for Osteoarthritis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Osteoarthritis.

Psoriatic arthritis: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Inflammatory arthritis in a patient with psoriatic skin lesions suggests psoriatic arthritis.

CONFIRMING DIAGNOSIS X-rays confirm joint involvement and show:

❑ erosion of terminal phalangeal tufts

❑ “whittling” of the distal end of the terminal phalanges

❑ “pencil-in-cup” deformity of the distal interphalangeal joints

❑ relative absence of osteoporosis

❑ sacroiliitis

❑ atypical spondylitis with syndesmophyte formation. Hyperostosis and paravertebral ossification result, which may lead to vertebral fusion.

Blood studies indicate negative rheumatoid factor and elevated erythrocyte sedimentation rate and uric acid levels.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Rheumatoid arthritis: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Typical clinical features suggest this disorder, but a definitive diagnosis is based on laboratory and other test results:

❑ X-rays — in early stages, show bone demineralization and soft-tissue swelling; later, loss of cartilage and narrowing of joint spaces; finally, cartilage and bone destruction and erosion, subluxations, and deformities

❑ rheumatoid factor test — positive in 75% to 80% of patients as indicated by a titer of 1:160 or higher

❑ synovial fluid analysis — reveals increased volume and turbidity but decreased viscosity and complement (C3 and C4) levels; white blood cell count usually exceeds 10,000/µl

❑ erythrocyte sedimentation rate — elevated in 85% to 90% of patients (may be useful to monitor response to therapy because elevation commonly parallels disease activity)

❑ complete blood count — usually reveals moderate anemia and slight leukocytosis.

A C-reactive protein test can help monitor response to therapy.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Osteoarthritis: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

A thorough physical examination confirms typical symptoms, and absence of systemic symptoms rules out an inflammatory joint disorder. X-rays of the affected joint help confirm diagnosis of osteoarthritis but may be normal in the early stages. X-rays may require many views and typically show:

❑ narrowing of joint space or margin

❑ cystlike bony deposits in joint space and margins and sclerosis of the subchondral space

❑ joint deformity due to degeneration or articular damage

❑ bony growths at weight-bearing areas

❑ fusion of joints. (See Digital joint deformities, page 591.)

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Juvenile rheumatoid arthritis: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Persistent joint pain and the rash and fever clearly point to JRA. Laboratory tests are useful for ruling out other inflammatory or even malignant diseases that can mimic JRA. Disease activity and response to therapy can also be monitored through laboratory results.

❑ Complete blood count shows decreased hemoglobin levels, neutrophilia, and thrombocytosis.

❑ Erythrocyte sedimentation rate and C-reactive protein, haptoglobin, immunoglobulin, and C3 complement levels may be elevated.

❑ ANA test may be positive in patients who have pauciarticular JRA with chronic iridocyclitis.

❑ RF is present in 15% of JRA cases, compared with 85% of rheumatoid arthritis cases.

❑ Positive HLA-B27 antigens may forecast later development of ankylosing spondylitis.

❑ X-rays in early stages reveal changes, including soft-tissue swelling, effusion, and periostitis in affected joints. Later, osteoporosis and accelerated bone growth may appear, followed by subchondral erosions, joint space narrowing, bone destruction, and fusion.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Psoriatic arthritis: Diagnosis
(Handbook of Diseases)

Inflammatory arthritis in a patient with psoriatic skin lesions suggests psoriatic arthritis. X-rays confirm joint involvement and show:

❑ marginal erosion at interphalangeal joints with areas of thin, “fluffy” new bone formation

❑ “whittling” of the distal end of the terminal phalanges

❑ “pencil-in-cup” deformity of the distal interphalangeal joints

❑ relative absence of osteoporosis

❑ sacroiliitis

❑ atypical spondylitis with syndesmophyte formation, resulting in hyperostosis and paravertebral ossification, which may lead to vertebral fusion.

Blood studies indicate negative rheumatoid factor and elevated erythrocyte sedimentation rate and uric acid levels.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Rheumatoid arthritis: Diagnosis
(Handbook of Diseases)

Typical signs and symptoms suggest RA, with a firm diagnosis supported by laboratory and other test results:

❑ X-raysin early stages show bone demineralization and soft-tissue swelling; later, loss of cartilage and narrowing of joint spaces; and finally, cartilage and bone destruction and erosion, subluxations, and deformities.

❑ RF is positive in 75% to 80% of patients, as indicated by a titer of 1:160 or higher.

❑ Synovial fluid analysisshows increased volume and turbidity but decreased viscosity and elevated white blood cell counts (often greater than 10,000/µl).

❑ Serum protein electrophoresis may show elevated serum globulin levels.

❑ Erythrocyte sedimentation rate and C-reactive protein are elevated in 85% to 90% of patients (may be useful to monitor response to therapy because elevation typically parallels disease activity).

❑ Complete blood count usually shows moderate anemia, slight leukocytosis, and thrombocytosis.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Osteoarthritis: Diagnosis
(Handbook of Diseases)

A thorough physical examination confirms typical symptoms, and the absence of systemic symptoms rules out an inflammatory joint disorder. X-rays of the affected joint help confirm diagnosis of osteoarthritis but may be normal in the early stages. X-rays may require many views and typically show:

❑  narrowing of joint space or margin

❑  cystlike bony deposits in joint space and margins

❑  sclerosis of the subchondral space

❑  joint deformity due to degeneration or articular damage

❑ bony growths at weight-bearing areas

❑  fusion of joints.

No laboratory test is specific for osteoarthritis.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Juvenile rheumatoid arthritis: Diagnosis
(Handbook of Diseases)

Persistent joint pain, rash, and fever clearly point to JRA. Laboratory tests are useful for ruling out other inflammatory or even malignant diseases that can mimic JRA and for monitoring disease activity and response to therapy.

❑ Complete blood count shows decreased hemoglobin levels, neutrophilia, and thrombocytosis.

❑ Erythrocyte sedimentation rate, complement (C)-reactive protein, haptoglobin, immunoglobulin, and C3 levels may be elevated.

❑ Test results may be positive for ANAs in patients who have pauciarticular JRA with chronic iridocyclitis.

❑ RF is present in 15% of patients with JRA, as compared with 85% of patients with RA.

❑ Positive HLA-B27 test may forecast later development of ankylosing spondylitis.

❑ Early X-ray changes include soft-tissue swelling, effusion, and periostitis in affected joints. Later, osteoporosis and accelerated bone growth may appear, followed by subchondral erosions, joint space narrowing, bone destruction, and fusion.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

 » Next page: Signs of Osteoarthritis

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