Every day in the United States, people seek out their doctors’ expertise in helping to explain their joint pain, stiffness, swelling, and fatigue. Often, the culprit is arthritis.
Making an Arthritis Diagnosis
Arthritis is a common diagnosis and if you think you may have it, your family doctor or internist is a good place to start. Beginning with a physical and some basic tests looking for common forms of arthritis, your doctor can help steer you in the right direction toward an orthopedist or a rheumatologist.
The overview below shows the path your doctors may take to assess your joint issues, either diagnosing arthritis or ruling it out.
Learn more about arthritis, including the different types of arthritis.
Could It Be Arthritis?
An evaluation for arthritis will usually begin with questions and answers as your doctor examines your symptoms as well as your family and personal medical history.
- When did your symptoms start
- Are your symptoms intermittent or constant?
- Do you have joint stiffness? When and for how long does it last?
- What’s your pain level?
- Have you found a way to relieve your pain temporarily?
- Does anyone in your immediate or extended family have any arthritis or rheumatic disease?
- Do autoimmune diseases run in your family?
Your Health History (to Present)
- Have you recently dealt with any illnesses?
- Do you have an autoimmune condition?
- Is it possible you were exposed to Lyme disease?
- What medications, supplements, and vitamins do you take?
- Does your job require prolonged standing, kneeling, sitting, or repetitive motion?
- What, if any, joint injuries have you incurred?
- Do you play contact sports or sports that require quick pivots?
- Do you have any chronic health conditions like hypertension or diabetes?
- Where have you traveled?
- Do you exercise regularly – and what exercise do you do and how often?
- What is your sleep regimen and do you get enough sleep?
- Do you smoke?
- What is the breakdown of healthy versus fatty foods in your diet?
- Do you have excessive stress in your life?
- Do you have any mental health conditions like depression or anxiety?
When your doctor does a joint evaluation to look for arthritis or another medical condition, you can expect a thorough, detailed exam. You can also expect that your doctor will do the following during your exam:
- Check each joint to see which are affected
- Palpate your affected joint(s) for warmth, inflammation, and fluid retention
- Check your joints’ range of motion by moving them back and forth
- Evaluate tenderness over the joints
- Assess joint symmetry; i.e., is the same joint affected on both sides of your body?
- Test your reflexes
- Make sure you aren’t running a fever or showing signs of infection or acute illness
Testing for Arthritis
After the health history assessment and physical exam, your doctor will probably order imaging or laboratory tests, depending on the findings thus far.
The goal of imaging is to assess affected joints for signs of degeneration and erosion, changes due to aging or chronic injury, bone spurs, cartilage loss, fractures, soft tissue tears, swelling, fluid retention or loose soft tissue particles.
- X-rays are usually the first imaging performed and can show signs of arthritis including narrowing joint space and bone overgrowth
- MRI is used to provide greater detail to X-ray findings or to search for the cause of symptoms that X-rays don’t find
Blood drawn in the lab can detect inflammation, dysfunctionality of organs and cells, presence of antibodies, and more. Examples of serum (blood) values assessed include:
- Antinuclear antibody (ANA) test to assess antibody levels
- Complete blood count (CBC) to detect levels of red and white blood cells in addition to platelets
- Creatinine to look for kidney disease
- CCP (cyclic citrullinated peptide) antibody tests to look for rheumatoid arthritis
- Sedimentation rate to detect inflammation in the body
- RF (rheumatoid factor) to look for antibodies that would be present in rheumatoid arthritis
- Uric acid measurement to help diagnose gout
In addition to imaging and blood draw, your doctor may order other tests including:
- HLA tissue typing to look for the presence of genetic markers of ankylosing spondylitis
- Joint aspiration (arthrocentesis) to abstract and test a joint’s synovial fluid for bacteria or viruses
- Muscle biopsy to check tissue samples for various muscle diseases
- Skin biopsy to examine tissue and identify or rule out skin-related arthritis like lupus or psoriatic arthritis
- Urine test to check calcium levels and look for issues with blood cells
Waiting for a Diagnosis
Because arthritis comes in more than 100 forms—and other conditions can affect the joints, too—confirming a diagnosis takes a little time. While you wait, your doctor can help you alleviate your symptoms by prescribing a number of therapies, including:
- Heat-and-cold treatments
- Rest, when indicated
- Corticosteroid injections
- Physical therapy
- NSAIDs (non-steroidal anti-inflammatory medications)