How Is It Diagnosed?

How Is Osteoarthritis Diagnosed?

The Process of Diagnosing Osteoarthritis:

The onset of Osteoarthritis and the associated symptoms are subtle in nature.  Osteoarthritic changes to joint structure occur over a period of time, usually years, and signs and symptoms of the disease appear gradually.  A complete history of Osteoarthritic symptoms such as crepitus (thecrackling or popping sounds and sensations in a specific joint), pain, and immobility will only be revealed by patients to their physicians when a thorough case history is taken.  An extensive case history is very valuable as it will reveal an accurate representation of the signs and symptoms of OA. Without a thorough case history and a tested pain scale the patient will likely experience inadequate pain management, increased joint degradation, muscle wasting, impaired healing, weakness, and patient suffering can result.

X-Ray:

In addition to lab tests, X-rays (radiographs) may also be used in the diagnosis of OA.  According to the American College of Rheumatology criteria for the diagnosis and classification of Osteoarthritis, X-Ray (plain radiograph) remains one of the best diagnostic tools in the assessment of the severity of OA.  Radiographic evidence of OA is in most cases diagnostic, and is highly consistent with the severity of the disease.  More advanced cases of OA will demonstrate greater amounts of cartilage and joint degradation upon X-Ray examination.  Some typical X-Ray changes seen in OA, may include cartilage loss resulting and presenting as asymmetrical joint-space narrowing, increases in bone density, subchondral cyst formation, osteophyte formation, and deformities at the end of bones in severe OA. Evidence of cartilage loss resulting in joint-space narrowing, and of the presence of osteophytes and sclerosis or increased bone density, are the two main criteria for the radiographic diagnosis of OA.

The Importance Of A Proper Diagnosis:

A complete patient history and a complete physical could prevent unnecessary suffering in both elderly and younger arthritis sufferers.  One example of unnecessary suffering that occurs when physicians do not thoroughly investigate patients’ symptoms is in the case of elderly patients.  Though the primary symptom that Osteoarthritic patients report to physicians with is pain, older patients tend to underreport the intensity of their pain to physicians.  The failure by the elderly to fully disclose the entire scope of their pain to physicians is especially alarming, because studies have found that sensitivity to pain increases with age.  Aside from pain management, a complete physical is also necessary for the diagnosis of OA.  Other signs including crepitus, bony enlargements, reduced range of motion in affected joints, and tenderness upon the palpation of affected joints can all be detected with a complete physical.  Laboratory tests can also be conducted and may assist in the diagnosis of OA, primarily helping to rule out other conditions such as Rheumatoid Arthritis and lupus, which may present with signs and symptoms similar to OA.  Although it is not sufficient evidence for the diagnosis of OA, laboratory testing may reveal reduced white blood cells counts and the presence of proteins that contribute to the inflammatory process in the disease.