April 11, 2008

Diagnosing Osteoarthritis – Physical Examination & Tests for Detection

Posted in Category : Bone, Joint & Muscles Disorders

Early diagnosis of degenerative osteoarthritis, which is caused due to breakdown and loss of cartilage, is very important to seek the appropriate treatment as this disease can cause stiffness, pain, inflammation and restrictions in the mobility of the joints of knee, feet, hands, spine, wrists and hip. There are various options for diagnosing osteoarthritis such as blood tests, imaging tests and joint fluid analysis.

Generally, diagnosing osteoarthritis is based on the physical examination, symptoms and medical history of the patient. A rheumatologist first gets the information about joint symptoms, traumatic injuries, current or previous illness, allergies, family history and other medical conditions. During physical examination of the patient, the doctor checks the affected joints for redness, swelling, warmth, skin rashes, tender points and other symptoms. The flexibility and mobility of the joints is also checked during physical examination.

After the physical examination, different laboratory tests are suggested by the doctor for diagnosing osteoarthritis. The blood tests are performed to rule out other types of arthritis which include determination of rheumatoid factor (RF) and detection of human leukocyte antigen (HLA-DR1 and HLA-DR4) that are more common in inflammatory arthritis like rheumatoid arthritis. Determination of uric acid is another blood test done to rule out the possibility of gout.

Besides these blood tests, analysis of synovial fluid is also important investigation for diagnosing osteoarthritis. This fluid is aspirated from the joint through a needle and it is tested for viscosity, chemistry, overall appearance, blood cell counts and micro-organisms. In osteoarthritis, the synovial fluid is usually clear, while it is cloudy in rheumatoid arthritis because of presence of several white blood cells. The fluid is tested for the presence of crystals to rule out gout.

In addition to these laboratory tests, the imaging tests like x-ray contribute in the diagnosis of osteoarthritis. Common x-rays findings in osteoarthrtits are narrowing of joint space, formation of bony spurs and formation of cysts. Besides this, arthroscopy is a useful procedure to detect the damage and abnormalities in the cartilage and ligaments.

After the diagnosis, treatment option is selected in the basis of severity of symptoms and medical history of the patient. The osteoarthritis medications include painkillers like acetaminophen, propoxyphene and codeine, non-steroidal anti-inflammatory drugs and corticosteroids. Exercise, application of heat or cold, various therapies such as physiotherapy, hydrotherapy and massage are also beneficial for the treatment. Weight loss, intake of balanced and healthy diet, using assistive devices and avoiding stress on the joints are some preventive measures for osteoarthritis.