Arthritis
Arthritis Symptoms and Diagnosis
Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints.
Osteoarthritis usually develops slowly and can occur in any joint. Early in the disease, joints may ache after physical work or exercise. Most often, osteoarthritis occurs in the hands, hips, knees, neck, or low back.
Common signs of osteoarthritis include joint pain, swelling, or tenderness; stiffness after getting out of bed; and a crunching feeling or sound of bone rubbing on bone. Not everyone with osteoarthritis feels pain, however. In fact, only a third of people with x-ray evidence of osteoarthritis report pain or other symptoms.
Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish.
Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Symptoms differ from person to person, and can be more severe in some people than in others.
Gout usually first attacks the joints in the big toe. Hyperuricemia -- high levels of uric acid in the body -- contributes to arthritis that develops in one day, producing a swollen, red, and painful joint.
It is important for people with joint pain to give the doctor a complete medical history. Answering these questions will help your doctor make an accurate diagnosis:
Is the pain in one or more joints?
When does the pain occur and how long does it last?
When did you first notice the pain?
Does activity make the pain better or worse?
Have you had any illnesses or accidents that may account for the pain?
Is there a family history of any arthritis or rheumatic diseases?
What medicines are you taking?
No single test can diagnose osteoarthritis. When a person feels pain in his or her joints, it may or may not be osteoarthritis.
The doctor will use a combination of tests to try to find out if osteoarthritis is causing the symptoms. A patient's attitudes, daily activities, and levels of anxiety or depression have a lot to do with how severe the symptoms of osteoarthritis may be.
Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others.
Also, symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. Finally, the full range of symptoms develops over time, and only a few symptoms may be present in the early stages.
Because no single test can diagnose osteoarthritis or rheumatoid arthritis, most doctors use a combination of methods and tests including a medical history, a physical examination, x-rays, and laboratory tests.
A medical history is the patient's description of symptoms and when and how they began. The description covers pain, stiffness, and joint function, and how these have changed over time.
A physical examination includes the doctor's examination of the joints, skin, reflexes, and muscle strength. The doctor observes the patient's ability to walk, bend, and carry out activities of daily living.
X-rays are limited in their capacity to reveal how much joint damage may have occurred in osteoarthritis and rheumatoid arthritis. X-rays usually don't show osteoarthritis damage until there has been a significant loss of cartilage. X-rays are also not useful in the early stages of rheumatoid arthritis before bone damage is evident. However, x-rays can be used later to monitor the progression of the disease.
One common test for rheumatoid arthritis is the rheumatoid factor test. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease.
Other common tests for rheumatoid arthritis include the erythrocyte sedimentation rate which indicates the presence of inflammation in the body; a test for white blood cell count; and a blood test for anemia.
To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. If crystals are found in the joint fluid, the person usually has gout.
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