Osteoarthritis of the major joints is most effectively diagnosed through a combination of medical history, physical examination, and various lab tests including imaging studies such as X-ray. A primary care physician can diagnose most cases, but depending on perceived severity a patient may be referred to a specialist, such as a physiatrist or orthopedic surgeon, for further evaluation.

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Medical History

Medical histories can often be the most useful tool for physicians in diagnosing osteoarthritis. Practitioners will look for family history of the disease as well as the presence of various risk factors to indicate the need for further testing. A careful review of the patient’s symptoms is important to obtaining an accurate diagnosis.

Physical Examination

A physical examination will usually follow the medical history as the physician looks for physical signs of the disease. These include swelling and tenderness of the joints, loss of movement in specific joints, or visible joint damage such as bony growths in the surrounding area. The patient may also be asked to perform a variety of physical tasks so the physician can evaluate range of motion and general joint mobility.

Lab Tests

Laboratory tests are used to help confirm a suspected diagnosis of osteoarthritis if the diagnosis is otherwise in doubt.

  • Joint aspiration or arthrocentesis. This diagnostic tool involves removing a sample of fluid from the joint for further examination, and can be used to rule out other conditions. Further testing can reveal the presence of crystals and also rule out infection.
  • X-ray. An X-ray is used to provide a picture of potential joint damage, but is not the most reliable tool. Most patients over the age of 60 display joint degeneration associated with osteoarthritis, but only a third or this population report actual symptoms. For this reason, an X-ray is usually used to confirm a suspected diagnosis made through a physical examination and medical history.
  • MRI. Magnetic resonance imaging techniques can be used to provide a more accurate picture of damage to the joint and remaining cartilage.

The above combination of medical history, physical exam, and possibly diagnostic testing, all inform the diagnosis of osteoarthritis.

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Written by Grant Cooper, MD
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