Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. To make a diagnosis, most doctors use a combination of methods and tests including a medical history, a physical examination, x rays, and laboratory tests.
It is important for people with joint pain to give the doctor a complete medical history. Answering these questions will help your doctor make an accurate diagnosis:
- Is the pain in one or more joints?
- When does the pain occur and how long does it last?
- When did you first notice the pain?
- Does activity make the pain better or worse?
- Have you had any illnesses or accidents that may account for the pain?
- Is there a family history of any arthritis or rheumatic diseases?
- What medicines are you taking?
- A medical history is the patient's description of symptoms and when and how they began. The description covers pain, stiffness, and joint function, and how these have changed over time.
- A physical examination includes the doctor's examination of the joints, skin, reflexes, and muscle strength. The doctor observes the patient's ability to walk, bend, and carry out activities of daily living.
Symptoms and Diagnosis - Osteoarthritis
The doctor will use a combination of tests to try to find out if osteoarthritis is causing the symptoms. A patient's attitudes, daily activities, and levels of anxiety or depression have a lot to do with how severe the symptoms of osteoarthritis may be.
Osteoarthritis usually develops slowly and can occur in any joint, but often occurs in weight bearing joints. Early in the disease, joints may ache after physical work or exercise. Most often, osteoarthritis occurs in the hands, hips, knees, neck, or low back.
Common signs of osteoarthritis include joint pain, swelling, and tenderness; stiffness after getting out of bed; and a crunching feeling or sound of bone rubbing on bone. Not everyone with osteoarthritis feels pain, however. In fact, only a third of people with x-ray evidence of osteoarthritis report pain or other symptoms.
X-rays are limited in their capacity to reveal how much joint damage may have occurred in osteoarthritis. X-rays usually don't show osteoarthritis damage until there has been a significant loss of cartilage.
Quiz
1. Osteoarthritis
A. occurs more commonly in weight bearing joints
B. usually develops slowly
C. may cause joints to ache after physical work or exercise
D. all of the above
D is the correct answer. Osteoarthritis usually develops slowly and most commonly in weight bearing joints. Early in the disease, joints may ache after physical work or exercise.
2. Common signs and symptoms of osteoarthritis can include
A. pain
B. swelling
C. tenderness
D. all of the above
D is the correct answer. Common signs and symptoms of osteoarthritis include joint pain, swelling, and tenderness.
3. As a tool for diagnosing osteoarthritis, x rays are
A. not useful
B. limited in their usefulness
C. the only way a doctor can make a diagnosis
B is the correct answer. X rays are often used in combination with other methods to diagnose osteoarthritis. However, x rays are limited in their capacity to reveal how much joint damage may have occurred, and they do not usually show osteoarthritis damage until significant cartilage loss occurs.
4. Which of the following is not a sign or symptom of osteoarthritis?
A. joint pain
B. stiffness
C. fever
D. bone rubbing on bone
C is the correct answer. Common signs of osteoarthritis include joint pain, stiffness after getting out of bed, and a crunching feeling or sound of bone rubbing on bone. Fever is not a symptom of osteoarthritis.
5. Osteoarthritis
A. develops suddenly.
B. always causes pain.
C. usually occurs in the hands, hips, knees, low back or neck.
C is the correct answer. Osteoarthritis usually comes on slowly and can occur in any joint. Most often, it occurs in the hands, hips, knees, low back, or neck. Not everyone with osteoarthritis feels pain, however. In fact, only a third of people with x-ray evidence of osteoarthritis report pain or other symptoms.
Symptoms and Diagnosis - Rheumatoid Arthritis
Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish.
Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected.
Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others.
One common test for rheumatoid arthritis is the rheumatoid factor test. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. Another test is called the citrulline antibody test.
Other common tests for rheumatoid arthritis include the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body; a test for white blood cell count; and a blood test for anemia.
Also, symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. Finally, the full range of symptoms develops over time, and only a few symptoms may be present in the early stages.
Quiz
1. Rheumatoid arthritis predominantly involves inflammation of the tendons.
FALSE is the correct answer. Rheumatoid arthritis predominantly involves inflammation of the joint lining.
2. Rheumatoid arthritis generally occurs in a symmetrical pattern.
TRUE is the correct answer. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one hand is affected, the other one usually is, too.
3. Rheumatoid arthritis is easy to diagnose in its early stages.
FALSE is the correct answer. Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single diagnostic test for the disease. Secondly, symptoms differ from person to person and can be more severe in some people than in others.
4. Certain tests, such as the rheumatoid factor test, are useful in diagnosing rheumatoid arthritis.
TRUE is the correct answer. Some tests that doctors use to help diagnose rheumatoid arthritis include the rheumatoid factor and the citrulline antibody test.
5. It is difficult to diagnose rheumatoid arthritis because there is no single test for the disease.
TRUE is the correct answer. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others.
Symptoms and Diagnosis - Gout
Hyperuricemia -- high levels of uric acid in the body -- contributes to arthritis that develops in one day, producing a swollen, red, and painful joint. Gout attacks usually begin at night.
Gout typically attacks one joint at a time. Gout normally attacks joints in the lower part of the body, such as the knee, ankle or big toe. For many people the joints in the big toe are the first to be attacked. In fact, sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients.
To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. If crystals are found in the joint fluid, the person usually has gout.
Quiz
1. Gout attacks usually begin
A. in the morning
B. in the afternoon
C. at night
C is the correct answer. Gout attacks may begin anytime but frequently start at night.
2. Sometime during the course of the disease, gout usually affects the joints in the
A. thumb
B. big toe
C. knee
B is the correct answer. Sometime during the course of the disease, gout usually affects the joints in the big toe. The big toe becomes swollen, red, and painful.
3. The final step in confirming a diagnosis of gout is to
A. take x rays
B. get the patient's medical history
C. examine a sample of synovial fluid from the inflamed joint
C is the correct answer. To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of joint fluid for analysis under a microscope.
4. A person usually has gout if __________ are present in a sample of joint fluid.
A. monosodium urate crystals
B. proteins
C. red blood cells
A is the correct answer. If monosodium urate crystals are seen when looking at the fluid under a special microscope, the person usually has gout.
5. Gout
A. usually affects young women.
B. most often affects one joint at a time.
C. always causes flu-like symptoms.
B is the correct answer. Gout usually affects a single joint. In rare cases, many joints are affected at the same time. Gout frequently affects a joint in the lower part of the body such as a knee, ankle, or toe. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients.
