How Arthritis Is Diagnosed
Posted by William on February 20, 2012
There are a number of factors a physician takes into account when attempting to diagnose arthritis and then differentiating which type of arthritis a patient may have. Symptoms may range from morning stiffness, pain, swelling, joint heat and fever, to bony malformations and constitutional complaints, such as depression. Your clinician will begin by taking your detailed history and doing a physical exam.
You will likely be asked questions about the severity, location and duration of pain and stiffness, as well as:
Whether it is morning pain and how long it lasts.
Whether rest affects the joint pain.
The effect on weight bearing joints.
Whether anyone in your family has had arthritis.
What drugs, if any, you take.
Your physician will conduct a detailed physical examination after taking your history.
Which Joints Are Most Prone to Which Type of Arthritis?
Rheumatoid arthritis (RA) will generally manifest as small joint pain simultaneously affecting corresponding parts of the hands or feet or wrists, with tenderness and swelling, and sometimes fever. RA is a disease of the joint’s lining.
Osteoarthritis (OA) will generally manifest as joint pain that affects larger joints, one at a time. It is a disease of the joint’s cartilage cushions.
Arthritis symptoms may also be indicative of a number of non-arthritis related conditions, and your physician may order blood tests to further assist him or her in correctly diagnosing your condition.
What Tests Assist the Physician in Diagnosing Arthritis?
Blood may be tested for rheumatoid factor (RF) or antinuclear antibodies (ANA), and to determine the erythrocyte sedimentation rate (ESR). Your doctor may also order X-rays.
ANA test — The antinuclear antibodies test looks for abnormal antibodies. The presence of these antibodies or testing positive for ANA may indicate lupus or rheumatoid arthritis.
RF test — The rheumatoid factor test looks for antibodies that are typically present at high levels in patients with rheumatoid arthritis. Patients with rheumatoid arthritis may test negative for RF and later test positive. It is not a definitive diagnostic tool.
ESR test — The erythrocyte sedimentation rate is a test that measures for inflammation. An elevated ESR indicates that there is inflammation in the body. Inflammation may have causes other than arthritis.
Blood count — Base line, complete blood count and blood chemistry studies are helpful to determine what drugs should be used and for how long. Liver and kidney function may be affected by medications, so tests to determine the health of those organs may be ordered.
X-rays — Your physician may want to check for bony spurs or joint malformation by ordering X-rays of your affected joints.
Definitive Diagnosis
Once your physician has information back from the laboratory, a diagnosis will be based on your history, physical and the laboratory results. Given the non-definitive nature of some testing, the astute practitioner will base the diagnosis on all three components: experience, the tests and the symptoms.
After a diagnosis is made, your physicians will come up with a treatment plan for your particular type of arthritis. Many patients receive treatments involving drug therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) or perhaps disease-modifying anti-rheumatic drugs (DMARDs).
Your physician may refer you to another physician known as a rheumatologist, a doctor who, after medical school and training in either internal medicine or pediatrics, has devoted additional years to specialized rheumatology training. Rheumatologists specialize in the treatment of arthritis and other diseases of the joints, muscles and bone. The rheumatologist may work with your primary care physician as a consultant.