Arthritis Diagnosis

Diagnosing rheumatic diseases can be difficult because some symptoms and signs are common to many different diseases. Family doctors may help you with an initial consultation, but should then refer you to a rheumatologist (a doctor who specializes in treating arthritis and other rheumatic diseases).

First, it's helpful to keep a daily journal that describes arthritic pain over time. Record what the affected joint looks like, how it feels, how long the pain lasts, and what you were doing when the pain started.  You may also want to ask yourself these questions to help you prepare for a medical appointment:

• Is the pain in one or more joints?
• When did you first notice the pain?
• What were you doing when you first noticed the pain?
• When does the pain occur?
• How long does the pain last?
• Are you experiencing any other symptoms besides pain?
• Is there a family history of arthritis or other rheumatic disease?
• Does activity make the pain better or worse?
• Have you had any illnesses or accidents that may account for the pain?
• Have you had any recent infections?
• What medicine(s) are you taking?

Physical exam
A rheumatologist will review your medical history and conduct a physical examination to understand what's happening in the body.  During a physical exam, the doctor will examine the joints for redness, warmth, damage, ease of movement, and tenderness. Because some forms of arthritis may affect internal organs, a complete physical examination that includes the heart, lungs, abdomen, nervous system, eyes, ears, mouth, and throat may be necessary.

Laboratory tests
The doctor may then order some laboratory tests to help confirm a diagnosis. Samples of blood, urine, or synovial fluid (lubricating fluid found in the joint) may be needed for the tests. Many of these same tests may be useful later for monitoring the disease or the effectiveness of treatments.  Common laboratory tests and procedures include:

• Antinuclear antibody (ANA)
• CCP (or anti-CCP)
• C-reactive protein test
• Complement blood test
• Complete blood count (CBC)
• Creatinine blood test
• Erythrocyte sedimentation rate (sed rate or ESR)
• Hematocrit (PCV, packed cell volume)
• Rheumatoid factor
• Synovial fluid examination
• Urinalysis

Imaging tests
X rays or other imaging tests may also be requested to confirm an arthritis diagnosis. X rays provide an image of the bones, but they do not show cartilage, muscles, and ligaments. Other noninvasive imaging methods such as CT scans, magnetic resonance imaging (MRI), and arthrography can display the entire joint.

Other exams
The doctor also may look for damage to a joint by using an arthroscope: a small, flexible tube which is inserted through a small incision at the joint.   Joint aspiration (or arthrocentesis) involves draining fluid from the joint for examination. This procedure can help rule out other medical conditions.

The doctor may need to see you more than once and possibly a number of times to make an accurate diagnosis.  But arthritis doesn't need to be a painful part of growing older. You and your doctor can work together to safely lessen the pain and stiffness that might be troubling you and to prevent more serious damage to your joints. To learn more about possible treatment plans, read our how to treat arthritis section next.