Tests Used to Reach a Proper Arthritis Diagnosis. 1
Posted by Green on January 5, 2010
Since there are over 100 different kinds of arthritis, finding a proper diagnosis can be a long and frustrating process. There are several ways a doctor evaluates a patient to determine what kind of arthritis he/she has.
Some of these evaluation tools may include a complete patient medical history, physical examination, x-rays, lab tests and a functional evaluation. Since some forms of arthritis have a genetic connection, a family history is also important.
One of the most common reasons people don’t get a proper diagnosis is they don’t go to the doctor for an evaluation. They have heard over the TV or read in a magazine or the newspaper; everyone will eventually suffer from the “minor aches and pains of arthritis.” The advertising has been so convincing that most people, and especially people over the age of 60, don’t seek out a proper diagnosis from a healthcare professional. Another reason people don’t get a proper diagnosis is they feel even if they do get a diagnosis, there isn’t much that can be done to treat the illness. These are both misconceptions that could lead to improper treatment or exhilaration of the disease process because of the lack of treatment.
Lets look at some general evaluation processes and how you can assist the doctor in reaching a proper diagnosis. Here is a list of some of the most commonly used tools:
1. Personal Medical History: The doctor is looking for several pieces of information that will give him/her information about you.
* Personal account of medical history
* Explanation of the current problem
* Report of any injury that may have caused the problem
* How long has the problem existed
* Is there swelling around the joint
* Is the joint stiff – if so, for how long
* Does the joint appear red and feel warm
* Is the joint painful – rate pain on a scale of 0 – 10 (0 being no pain)
* Is there anything you do that makes the pain worse/better
* Has this current problem made every day tasks difficult/impossible to do
2. Physical exam: The doctor will move the joints assessing them for range of motion. He will feel them for warmth, look at them to see if they appear red, evaluate for bony protrusions, tender spots, and inflammation. The doctor would also take a heart rate and blood pressure and examine the eyes, ears, and throat. Glands around the jaw and neck are evaluated and the stomach is examined.
3. X-Rays: The doctor may require x-rays of the problem joint. If x-rays of that joint had been taken in the past, the doctor would ask that the patient bring those x-rays along for comparison. These pictures are used to see if there have been any joint changes. Some changes in the cartilage, or surface of the bone might indicate the beginning of arthritis. The doctor would also be looking for changes in the joint space.
4. Lab test: There are many lab tests that can be done. Some of these tests are conducted to rule out other forms of the disease rather than to make a final diagnosis.
* Rheumatoid factor (RF) – This test is done as part of the evaluation for people who the doctor suspects have rheumatoid arthritis.
* Antinuclear antibody (ANA) – These antibodies may be found in the blood of people who have lupus. They can also indicate the presence of scleroderma, Lyme disease, polymyositis, sjogren’s syndrome or other forms of inflammatory arthritis.
* Uric Acid – This test is done to help doctors diagnose gout.
* HLA tissue typing – This test detects the presence of certain genetic markers in the blood that can help diagnosis ankylosing spondylitis and Reiter’s syndrome.
* Erythrocyte sedimentation rate – This is also sometimes referred to as the “sed rate.” A high sedimentation rate indicates a greater amount of inflammation. Inflammation is present in several forms of arthritis.
* Skin biopsy – Taking small samples of skin and examining them under the microscope can help doctors make a positive diagnoses for some types of arthritis.
* Muscle biopsy – By taking a biopsy of the muscle fibers, doctors can look for possible damage and this would help confirm a diagnosis for polymyositis.
* Joint fluid exam – The doctor extracts fluid from the joint with a needle and it is examined for uric acid crystals, which would help confirm a diagnosis for gout or bacteria, which may indicate an infection in the joint.
…to be continued…