Arthritis Diagnosis

Arthritis Diagnosis

Diagnosing arthritis may be difficult. There are more than 100 different types of arthritis. Many symptoms are similar among the different conditions affecting the joints. Arthritis may be generally categorized into the following groups: degenerative arthritis, inflammatory arthritis, metabolic arthritis, and infectious arthritis. Osteoarthritis (also known as degenerative arthritis) is the most common type. Rheumatoid arthritis and gout are two other more common types. To make an accurate diagnosis, a healthcare provider may need to:

  • Review your medical history and current symptoms.
  • Examine you, paying close attention to your joints.
  • Order laboratory tests, X-rays, and other imaging tests (such as an ultrasound or MRI).
  • Perform an arthrocentesis (the procedure of removing fluid from a joint).

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

When reviewing your medical history, your healthcare 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 healthcare 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 various 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. Synovial fluid is removed with a syringe and examined for cell counts, crystal analysis, culture, and other tests.
  • 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 healthcare provider 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.
  • Ultrasound. Ultrasound uses sound waves (not radiation) to see the quality of synovial tissue, tendons, ligaments, and bones.
  • 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.

Ice Packs vs. Warm Compresses For Pain

Photo of young woman holding an ice pack to her shin

It can sometimes be confusing whether to use heat or cold when treating sore muscles or an injury, but keep these facts in mind.

Heat

  • Brings more blood to the area where it is applied.
  • Reduces joint stiffness and muscle spasm, which makes it useful when muscles are tight.
  • Should NOT be used for the first 48 hours following and injury.

Types of warm packs or pads

Warm towel

  1. Dampen a towel with warm (not scalding) water.
  2. Apply to the affected area to relieve muscle spasm.

Heating pad
Be sure to protect any type of heating pad device from coming in direct contact with the skin. Precautions should be taken to avoid burns, especially if you have nerve damage, such as from diabetes or other conditions.

When muscles work, chemical byproducts are produced that need to be eliminated. When exercise is very intense, there may not be enough blood flow to eliminate all the chemicals. It is the buildup of chemicals (for example, lactic acid) that cause muscle ache. Because the blood supply helps eliminate these chemicals, use heat to help sore muscles after exercise.

Cold

  • Relieves pain by numbing the affected area.
  • Reduces swelling and inflammation.
  • Reduces bleeding.

Types of cold packs

Ice towel

  1. Dampen a towel with cold water.
  2. Fold it and place it in a plastic, sealable bag.
  3. Place the bag in the freezer for 15 minutes.
  4. Remove from freezer and place it on the affected area.

Ice pack or cold compress

  1. Put ice in a plastic, sealable bag.
  2. Fill partially with water.
  3. Seal the bag, squeezing the air out of it.
  4. Wrap the bag in a damp towel and apply to the affected area.

When an injury or inflammation, such as tendonitis or bursitis occurs, tissues are damaged. Cold numbs the affected area, which can reduce pain and tenderness. Cold can also reduce swelling and inflammation.

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