Ask the Expert

Edward V. A. Lim, M.D., Orthopaedic Surgeon
The Christ Hospital Orthopaedic and Sports Medicine Associates

Q: How is OA diagnosed?

A: An early accurate diagnosis is necessary so that appropriate treatment can be considered. To diagnose osteoarthritis(OA), your doctor will make assessments. These assestments include medical history, physical examination, imaging studies and laboratory tests. Your medical history will include information about past medical conditions, allergies, treatments, and surgical procedures as well as current medical issues to rule anything out that may be the possible causes of your symptoms. It is also necessary to determine whether the OA is primary or a secondary associated with another disease or condition. Primary osteoarthritis is usually age related.

Secondary OA may be post traumatic following an accident or degenerative osteoarthritis due to other medical conditions. The doctor may ask you to describe your symptoms; how it began, location of the pain and or other associated symptoms like stiffness, when do the symptoms commonly occur and what makes the symptoms better or worse.

The next and the most important step in diagnosis is the physical exam. During the physical examination your doctor will observe for any signs and symptoms which commonly are associated with OA. The doctor will look for joint swelling, tenderness, decreased flexibility and range of motion in joints.  As well as muscle weakness, visible joint damage (i.e., bony growths), crepitus.

X-rays are commonly used to confirm the diagnosis of osteoarthritis. X-rays can reveal asymmetry of joint compartments, osteophytes at the joint margins, joint space narrowing, and subchondral bone sclerosis. While MRI (magnetic resonance imaging) is a more sensitive imaging method it is used less often. MRI scans show soft tissues like cartilage and ligaments along with bone. In osteoarthritis, the routine laboratory tests are usually normal but may sometimes be done to rule out other types of arthritis especially, inflammatory types of arthritis like rheumatoid arthritis.

When to see a doctor
Most of us have joint aches and pains as we age which we often manage using over the counter medications and home remedies- such as hot or cold packs, massage and resting the joints when necessary and assistive devices like cane or walker. However, if the pain is severe enough to affect the activity of your daily living a doctor may be able to help you. It is important to see your doctor right away if you experience any of these symptoms:
- sudden swelling, warmth, redness along with pain in any joint
- joint pain accompanied by a fever and/or rash
- severe pain that prevents you from using the joint

For more information, please visit http://www.thechristhospital.com/Ortho.