Osteoarthritis diagnosis

Last modified: December 12, 2019

If you feel stiff and have pain in your joints you should contact a medical center for a diagnosis. There are several joint diseases that can cause similar problems, but osteoarthritis is one of the most common. It is possible to have a fairly good idea of whether you are suffering from osteoarthritis even without consulting a doctor by reading about common symptoms. On the other hand, it is important to get an osteoarthritis diagnosis in order to begin the right kind of treatment.

Who can diagnose osteoarthritis?

The professionals who usually make the first assessment are physiotherapists or general practitioners. Both of these professions work closely with patients with osteoarthritis and are capable of making a diagnosis. If they are uncertain of the assessment, however, they can refer the patient to an orthopedic surgeon. An orthopedic surgeon can make a more thorough examination and assessment.

Osteoarthritis symptoms, joint function and medical history as the basis for a diagnosis

Osteoarthritis is a clinical diagnosis. This means that it should be made based on the medical history, pain level and joint function. It is therefore likely that the patient will be asked to talk about how the condition started, how the joint works and how the pain feels. One question that may be relevant is whether any relatives have osteoarthritis. In addition to this, a clinical examination of the joint and sometimes different types of functional tests will be done. A standard way of doing this kind of functional test is to see how many times the patient can get up from a chair in 30 seconds.

An x-ray is not necessary

The diagnosis used to be made using an x-ray, something which we now know is not necessary. Today, we see osteoarthritis as a combination of structural changes (what is seen on the x-ray) and symptoms. Symptoms can arise long before we can see changes on an x-ray – usually many years before. The idea is that a person with pronounced symptoms should not have to go without treatment just because it is not visible on an x-ray. At the same time, a person with changes that are visible on the x-ray may not know about their disease because they do not have symptoms. Therefore, the diagnosis should be made in view of the need for treatment rather than based on x-ray images.

Despite this, an x-ray may be useful in certain cases, for example to distinguish it from rheumatoid arthritis. Rheumatoid arthritis may, in fact, present symptoms that are similar to people with osteoarthritis. In the event of an unclear diagnosis, another form of imaging can be used, known as MRI (magnetic resonance imaging). The purpose of this is mainly to differentiate from other diseases that affect soft tissues instead of the cartilage tissue, for example meniscus injuries in the knee or injuries to the joint capsule in the hip.

Assessing whether surgery is needed

Once a diagnosis has been made, the patient can start treatment. This should primarily take the form of customized, instructor-led training. If training is too painful, pain-relieving medications can be taken if necessary. If the patient is overweight, weight control may also be necessary to reduce the strain on the joints.

In cases where the basic treatment does not give the desired results, surgery may be appropriate. Whether this is necessary will be decided by an orthopedic surgeon together with the patient. The most common procedure is to replace the affected joint with a prosthetic joint. If a smaller joint is affected, such as a joint in the foot or hand, a stiffening operation may be appropriate.

Read more about different stages of osteoarthritis.