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Making a diagnosis of arthritis is often difficult and requires a long process. This article outlines two of the most important parts of the diagnostic process: physical examination and family and medical history.

Arthritis is a condition characterized by inflammation of joints and the presence of several non-specific symptoms. Due to the general nature of arthritis symptoms and the limited availability of specific biomarkers, making a diagnosis of arthritis is often difficult. If you present with symptoms that are associated with arthritis, then your family doctor will likely refer you a specialist known as a rheumatologist. The rheumatologist will use a combination of different methods to determine a diagnosis of arthritis. These include asking questions about symptoms, personal and family medical history, ordering blood tests and imaging tests.

Medical history

One of the first things that the rheumatologist will do is ask you about your personal and family medical history. This is important as it can help determine whether you actually have arthritis or a different condition, as several conditions can mimic arthritis symptoms.

These are the questions that your rheumatologist will ask when inquiring about your personal and family medical history:

  • When did you first present with symptoms?
  • What are your general symptoms? (The doctor will look for symptoms such as fatigue, tiredness, weight loss, loss of appetite and/or fever.)
  • How long have you had these symptoms for?
  • Have your symptoms been progressive or stable since you started experiencing them?
  • Which joints are involved?
  • Do you have a history of injury to the joint involved?
  • Are there specific times in the day when your symptoms are particularly bad and times in the day when they are better? Is there a pattern to your symptoms?
  • Do you play sports? If so, do you play contact sports?
  • What kinds of hobbies do you have?
  • What is your occupation? (People with some types of occupation, particularly ones that involve repetitive movement, have a higher risk of developing arthritis.)
  • Have you traveled out of the country recently? If so, where?
  • How have the symptoms affected your capability of carrying out daily activities?
  • Do you have a family history of arthritis? If so, what type of arthritis?
  • Do you have a family history of autoimmune disease? If so, which ones?
  • Have you been genetically tested for HLA-B27? (HLA-B27 is a gene that is present in patients with arthritis and other similar diseases.)

One of the most important parts of diagnosing arthritis is conducting a physical examination, as the earliest indication that you might be experiencing arthritis is the presence of joint pain and stiffness.

Physical examination

After the physician has asked questions about the symptoms, as well as details regarding your personal or family medical history, he or she will conduct a full physical examination.

The doctor will ask which joints your symptoms are presenting in and then examine that specific joints for signs of:

  • Swelling or inflammation
  • Redness
  • Warmth
  • Sensitivity or tenderness
  • Pain when moving the joint
  • Reduced ability to move the joint around (loss of range-of-motion)
  • Any abnormal bone growths around the joint
  • If the joints are not positioned correctly
  • Joint deformities
  • Whether you are feeling any symptoms in areas other than joints such as the eyes, lungs, and skin.

During the physical examination, your doctor will likely probe and move the sore joints. Furthermore, if the joints that are involved extend to the knees, hips, or ankles, the doctor will urge you to stand up and do exercises that use these joints to determine how well you can still use them.

Conducting a physical examination is an important part of making a diagnosis of arthritis as there are several other diseases that can lead to the development of similar symptoms. In fact, simple joint pain without the presence of any other arthritic symptoms is likely not going to be caused by arthritis, but some other problem.

These are the diseases that mimic symptoms associated with the two most common types of arthritis: osteoarthritis and rheumatoid arthritis:

  • Viral infections from viruses such as the flu and Lyme disease
  • Measles
  • Another type of arthritis known as gout
  • Chickenpox
  • Lupus
  • Injury to a joint
  • Inflammation of a tendon, a condition called tendinitis

It is vital that you tell your doctor everything truthfully, even if the answers are somewhat embarrassing. This is because there is no single diagnostic test for arthritis and therefore, your doctor will diagnose you based on what he or she he feels and notices, and importantly, what you tell him or her. As it is important to start treatment early on in the course of the disease, it is vital for the doctor to make a diagnosis as quickly as possible.

It is important to keep in mind that there is no fast, easy way to diagnose arthritis. A diagnosis of arthritis is difficult and takes a lot of conversations, physical examinations and diagnostic testing in order to confirm what you and your doctor might suspect.

  • Krabben, A., et al. "Concordance between inflammation at physical examination and on MRI in patients with early arthritis." Annals of the rheumatic diseases 74.3 (2015): 506-512.
  • Pham, Thao, et al. "Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion." Joint Bone Spine 72.3 (2005): 222-228.
  • Majithia, Vikas, and Stephen A. Geraci. "Rheumatoid arthritis: diagnosis and management." The American journal of medicine 120.11 (2007): 936-939.
  • Photo courtesy of SteadyHealth

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