How is it Diagnosed?
Osteoarthritis (OA) is diagnosed primarily based on clinical evaluation and radiographic
evidence. The diagnostic process begins with a detailed medical history and symptom
inquiry, particularly about joint pain, stiffness (especially after inactivity), decreased
range of motion, and functional impairment.
Physical examination focuses on affected joints, typically knees, hips, hands, or spine.
Hallmark findings include joint tenderness, crepitus (a crackling sound during
movement), bony enlargements, and limited movement. Inflammatory signs like warmth
or redness are typically absent or minimal in OA.
X-rays of the affected joints are the primary imaging tool. Classic findings include joint
space narrowing, osteophyte (bone spur) formation, subchondral sclerosis, and cysts.
MRI may be used for early detection or in complex cases, revealing cartilage loss,
synovial changes, and bone marrow lesions.
Laboratory tests are usually conducted to exclude other forms of arthritis, such as
rheumatoid arthritis or gout. These tests include erythrocyte sedimentation rate (ESR),
C-reactive protein (CRP), rheumatoid factor (RF), and anti-CCP antibodies. Joint
aspiration and synovial fluid analysis may be done in cases where diagnosis is uncertain
or infection is suspected.
Clinical diagnostic criteria, such as those by the American College of Rheumatology
(ACR), combine symptoms, physical findings, and radiographic features. Early diagnosis
helps initiate interventions to manage symptoms, prevent progression, and improve
quality of life.