diagnosis of arthritis

By redorangedog Latest Activity December 15, 2017 at 6:45 pm Views 2,951

redorangedog

Diagnosis

Osteoarthritis

Visit your GP if you believe that you have osteoarthritis (OA). Although there is no definitive test for osteoarthritis, he/she will ask about your symptoms. Make sure you give a good description of pain, any stiffness and joint function. Your GP may examine your joints including checking for bony swellings, joint tenderness, instability, excess fluid, creaking joint (crepitus) and restricted movement. They may check your muscles too, especially for muscle thinning.

The factors which may lead the GP to suspect OA include:

being over 50 years of age
persistent joint pain which gets worse if you use your joints more
having stiffness in the joints in the morning lasting less than half an hour
If your symptoms are slightly different from those listed above, your GP may think you have another form of arthritis. For example, if you have joint stiffness in the morning that lasts longer than an hour, you may have a more inflammatory form of arthritis.

Hip x-ray

Further tests

Further tests such as X-rays can confirm osteoarthritis, although an X-ray may not be needed. An X-ray can show bony spurs, the narrowing of spaces between bones or whether calcium has settled into a joint. X-rays cannot indicate the degree of pain you might feel.

Blood tests may be used only to exclude other possibilities. However, they are not always required.

If you have been diagnosed with osteoarthrits read our Living with Ostearthritis factsheet.

Rheumatoid arthritis

Rheumatoid arthritis (RA) can be difficult to diagnose and there is no single test.

A GP will ask about symptoms, check joints for swelling and assess how easily they move, examine your skin and test muscle strength. If it is thought that you have rheumatoid arthritis you will be referred to a rheumatologist for an X-ray. Some of the tests which may be carried out either by a rheumatologist or the GP are outlined below:

Blood tests

No blood test definitively diagnoses rheumatoid arthritis.

Erythrocyte sedimentation rate (ESR)

In an ESR test, a sample of blood is put into a tube. The red blood cells (erythrocytes) are then timed to see how fast they fall to the bottom of the tube (measured in millimetres per hour). If the rate is faster than usual, you may have an inflammatory condition, such as rheumatoid arthritis, because proteins present in inflammation make them fall faster.

C-reactive protein (CRP)

A CRP is a non-specific test which can indicate if there is inflammation anywhere in the body by checking how much CRP is present in your blood. CRP is produced by the liver and released into the bloodstream. Elevated levels show that there is inflammation.

Full blood count

The full blood count will assess the number of red blood cells, haemoglobin, white blood cells and platelets in the blood. A low number of red blood cells or specifically haemoglobin indicates anaemia. Anaemia is caused by an insufficiency of red blood cells/haemoglobin which carries oxygen. Five % of people with rheumatoid arthritis have anaemia. However anaemia can have many causes, including a lack of iron in your diet. Therefore having anaemia is not a definitive test for rheumatoid arthritis.

Rheumatoid factor

This blood test is designed to see if a specific antibody, known as the rheumatoid factor, is present in your blood. This antibody is present in 80 % of people with rheumatoid arthritis. However it cannot always be detected in the early stages of the condition. The antibody is also found in 5 % of people who do not have rheumatoid arthritis, so this test cannot confirm rheumatoid arthritis. If it is negative another antibody test (for anti-CCP) may be done which is more specific for the disease.

Joint imaging

X-rays of joints can help differentiate between different types of arthritis and a series of X-rays can give an indication of progression of rheumatoid arthritis. A chest X-ray may also be taken as both the disease and certain treatments (such as methotrexate) can affect your chest. Musculoskeletal ultrasound may be used to confirm the presence, distribution and severity of inflammation and joint damage. Magnetic resonance imaging (MRI) scans can show what damage has been done to a joint.

Psoriatic arthritis

Your doctor will ask if there is a family history of arthritis. MRI scans, ultrasound scans and X-rays can be used to help confirm diagnosis. Blood tests may be used to exclude other conditions. For example a test for rheumatoid factor will help rule out rheumatoid arthritis.

Juvenile idiopathic arthritis

The GP will ask questions and examine you to exclude other cond

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