How is osteoarthritis diagnosed? Do you have a suspicion that your joint stiffness, swelling, and pain may be caused by osteoarthritis? Not sure what comes next? Getting a diagnosis can be a scary process, but is absolutely necessary to understand how to treat, stop progress of a disease, and ultimately get you back on track to a life full of adventure.
If you are experiencing new onset joint pain, stiffness, or just something in your joint(s) feels off- figuring out what is going on is important.
Assuming and/or just trying to forget about the symptoms can actually lead to increased severity of symptoms if they aren’t addressed…
I meet people all the time wishing they had taken action sooner but instead assumed that osteoarthritis is just “normal” as you get older.
The reality is, the quicker you know what is going on, the quicker you are able to take action to reduce the symptoms and slow the progression.
Here are 4 ways doctors and other medical professionals use to rule in or rule out osteoarthritis.
1. Look at your symptoms
The first thing when diagnosing osteoarthritis, or truly any disease, is to look at what your symptoms are, when they occur, how severe they are, etc.
It helps to pay close attention to the things that cause the most pain, limitations, or impede your daily life. These are essential to being able to relay that information to your doctor so that they can get a clear picture of what is going on with your individual case.
There are symptoms that are common to osteoarthritis which are described in the video below. You can also read more about what osteoarthritis typically feels like in this post here.
Symptoms play a pivotal role when looking at how to diagnose osteoarthritis so knowing the common ones can give you vital information.
If you suspect osteoarthritis may be at the root of your symptoms, try and keep a journal of what is going on.
Note when the symptom goes on, how bad it is, and when it goes away/things you do to make the symptoms less severe. It is important for clinicians to get a clear story of what is going on so that they may begin to rule in and rule out different diagnoses they suspect.
With a journal you will better be able to track trends associated with your symptoms. For example, if you notice after you walk a certain distance or on concrete more pain or stiffness- associating these two things will help tremendously with the treatment plan.
2. Physical Exam by a professional
When you visit a doctor, one of the first questions they usually ask is about your symptoms. Hopefully, with that last bit of information, you are equipped with the knowledge and your journal of how your symptoms manifest so that you are able to tell your whole story to the doctor.
They will also likely ask you about previous medical history and figure out if there are any identifiable risk factors for OA in your life.
There are lots of risk factors that are associated with osteoarthritis including family history, level of activity, other health conditions like diabetes, among others.
Communication is extremely vital between you and the doctor or medical professional you are seeing. If you aren’t sure who to see to help you with your joint pain- read this article.
If a doctor doesn’t ask something you think they should have – don’t be afraid to speak up! Doctors are not perfect and any information you can relay to them may help with a better, more accurate diagnosis for your individual case.
What to expect
Say you made an appointment to address knee pain you have been experiencing. A physical exam may be part of the process on how to diagnose osteoarthritis.
The doctor will likely assess your knee and other joints for various hallmark signs of OA, some that you yourself may not have even noticed!
They will visually examine the joint(s) for swelling, asymmetry from side to side, different bony contours, etc. They will also feel your joint for warmth, tenderness, bony protrusions or knobs, muscle wasting (atrophy), pain, and crepitus.
They will also ask you to move the joint through the range of motion and then passively repeat this to assess your range of motion.
They will look at the way you walk (your gait) to assess for compensations or abnormalities.
They will then take this information and decide on the next step.
Imaging such as x-rays, MRIs, and other scans are commonly ordered to help diagnose osteoarthritis.
But, images on their own, don’t particularly give the whole picture.
Research has actually shown that just because you having findings of narrowing of the joint space, and wear to your cartilage- it doesn’t automatically mean pain.
“The prevalence of knee osteoarthritis
features on MRI in otherwise healthy, asymptomatic, uninjured knees is high—up to 43% in adults aged ≥40 years.”
This means that someone could have the exact same x-ray you do and may not experience any pain at all.
This is why your own personal history, signs and symptoms are the most relevant piece of information. This will give more insight into how to treat, stop progression, and return to your active lifestyle.
Imaging is simply an adjunct test to one’s history to give even more insight to the condition and is very useful in most instances.
What imaging can you expect?
The two most likely methods of imaging are X-rays and MRIs.
X-rays are typically used for bone and MRIs are typically used to look at soft tissues such as muscles, tendons, and ligaments.
On the x-ray the clinician will be looking for the most hallmark signs of OA: joint space narrowing, osteophyte formation (bone spurs), subchondral sclerosis (thickening of bone), and cysts (Braun, Hillary J., and Garry E. Gold, 2012).
The MRI will give a more in depth look at the muscles surrounding the affected joint as well as the cartilage damage that may occur with osteoarthritis.
Some level of caution
I often hear people seeking out an MRI or an x-ray to “see what is going on inside their joint”. The problem with this is that many of these images are unnecessary and can actually negatively impact your pain.
You cannot “unsee” your image once you get one. If the image is described or even looks worse than originally thought, you may actually begin to experience more pain…
This video below goes into when you should consider an MRI and when one may not be necessary.
4. Blood tests, Arthrocentesis
Blood tests and/or arthrocentesis (pulling fluid out from an affected joint with a needle) may be used in order to primarily rule out or exclude other diagnoses that may mimic osteoarthritis.
The primary one they will be looking for is rheumatoid arthritis. It is important to rule out rheumatoid arthritis as it does require different routes of treatment if discovered.
When looking at how is osteoarthritis diagnosed, there aren’t any specific blood markers that indicate the condition. There are certain things such as levels of inflammation, A1C, vitamin D, and other options for testing that could aid in ruling out other conditions and helping to create a treatment plan that may be necessary.
So I have osteoarthritis, now what?
If you have been told you have osteoarthritis based upon these above tests, I’m so glad you’re here. My main mission at Keep the Adventure Alive is to give you the best information possible along with hope to continue adventuring even with osteoarthritis.
I meet people ALL THE TIME who aren’t sure the first step they should take to reduce their pain and start tackling osteoarthritis.
I have taken the knowledge and experience from treating hundreds of people with osteoarthritis and created a step by step process that has helped so many get out of pain and get back to doing what they love.
This is inside the Arthritis Adventure Blueprint. Instead of scouring the internet and wasting time on supplements, fancy braces and other things that don’t work- now you have access to something that is tested and proven by a physical therapist!
Learn more about this step by step program below so you can get started on your adventure right now!
Braun, Hillary J., and Garry E. Gold. “Diagnosis of osteoarthritis: imaging.” Bone 51.2 (2012): 278-288.
Culvenor AG, Øiestad BE, Hart HF, et al. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. British Journal of Sports Medicine 2019;53:1268-1278.
Guest writer and contributor: Kayci Smith, SPT at the University of Utah
Disclaimer: This post is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Kuhn and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Move Well Age Well, LLC and Dr. Alyssa Kuhn, PT, DPT are not liable or responsible for any advice, course of treatment, diagnosis or any conclusions drawn, services or product you obtain through this post, video or site.