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Arthritis Diagnosis

Diagnosing arthritis may be difficult. Many symptoms are similar among the different conditions affecting the joints. To make an accurate diagnosis, a doctor may need to conduct the following:

  • Review your medical history and current symptoms

  • Examine you, paying close attention to your joints

  • Order laboratory tests, X-rays, and other imaging tests

What is involved in reviewing your medical history and your current symptoms?

When reviewing your medical history, your health care provider may ask the following questions:

  • Have you had any illnesses or injuries that may explain the pain?

  • Is there a family history of arthritis or other rheumatic diseases?

  • What medication(s) are you currently taking?

Your health care provider may also ask:

  • What symptoms are you having? For example, pain, stiffness, difficulty with movement, or swelling.

  • About your pain:

    • Where is it?

    • How long have you had it?

    • When do you have pain and how long does it last?

    • Describe your pain. (Constant, dull, throbbing, stabbing)

    • How intense is it? (on a scale of 1 to 10, with 1 being no pain, and 10, the worst pain)

    • What lessons the pain?

    • What makes it worse?

What is involved in laboratory testing?

In addition to a complete medical history and physical examination, the following are common laboratory tests:

  • Antinuclear antibody. This test measures blood levels of antibodies, which may be present in persons with some types of arthritis.

  • Arthrocentesis (also called joint aspiration). This is an exam of joint fluid. A thin needle is inserted into the joint. Fluid is removed the fluid with a syringe and examined.

  • Complement tests. This test measures the level of complement, a group of proteins in the blood. It is used to help diagnose and monitor systemic lupus erythematosus (SLE) and rheumatoid arthritis.

  • Complete blood count. Measures the number of white blood cells, red blood cells, and platelets present in a sample of blood. A low white blood count (leukopenia), low red blood count (anemia), or low platelet count (thrombocytopenia) are associated with some forms of arthritis or the medications to treat them.

  • Creatinine. A blood test to monitor for underlying kidney disease.

  • C-reactive protein. This is a protein that is elevated when there is inflammation in the body as in some types of arthritis.

  • Erythrocyte sedimentation rate (also called ESR or sed rate).  This measures how quickly red blood cells fall to the bottom of a test tube. It is also elevated when there is inflammation in the body. This occurs in some types of arthritis. 

  • Hematocrit (PCV, packed cell volume). Measures the number of red blood cells present in a sample of blood. Low levels of red blood cells (anemia) are common in people with some types of arthritis.

  • Rheumatoid factor. Checks for an antibody that is present in most people with rheumatoid arthritis.

  • Urinalysis. Laboratory examination of urine to check for kidney disease that may be associated with several types of arthritis.

  • Uric acid. It is elevated in gout. 

What imaging techniques may be used to diagnose arthritis?

Imaging techniques may give your physician a clearer picture of what is happening to your joint(s). Imaging techniques may include the following:

  • X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.

  • Magnetic resonance imaging (MRI). MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.

  • Arthroscopy. This procedure uses a thin tube containing a light and camera (arthroscope) to look inside the joint. The arthroscope is inserted into the joint through a small incision. Images of the inside of the joint are projected onto a screen. It is used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation, and to treat certain conditions.